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Cerebral amebiasis in the acquired immunodeficiency syndrome
E E Calore1, M J Cavaliere, N M Calore
1Department of Pathology, Emilio Ribas Institute, São Paulo, Brasil.
Acta Neurologica Belgica
|March 28, 1998
Summary
Cerebral amebiasis, a rare infection, occurred in an AIDS patient presenting with cognitive decline. Post-mortem examination revealed Acanthamoeba infection in the brain, highlighting a critical diagnosis for clinicians.
Area of Science:
- Neurology
- Infectious Diseases
- Pathology
Background:
- Cerebral amebiasis is an uncommon opportunistic infection.
- Acquired immunodeficiency syndrome (AIDS) patients are susceptible to rare infections.
- Early diagnosis of cerebral amebiasis in AIDS patients is challenging.
Observation:
- A 46-year-old homosexual male with AIDS presented with intermittent amnesia and right palpebral ptosis.
- Cerebrospinal fluid analysis showed 169 cells with 75% lymphocytes.
- Despite prompt hospitalization, the patient died within five days.
Findings:
- Necropsy revealed periventricular small vessel thrombosis, necrosis, and hemorrhage.
- The inflammatory response was minimal, characterized by CD-68 positive macrophages.
- Abundant Acanthamoeba trophozoites were identified in brain tissue and meninges.
Implications:
- This case underscores the importance of considering cerebral amebiasis in AIDS patients with unexplained encephalitis and cognitive deficits.
- Clinicians should maintain a high index of suspicion for this rare but potentially treatable condition.
- Prompt recognition and treatment are crucial for improving outcomes in cerebral amebiasis.