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Survival of an AIDS patient after infection with Acanthamoeba sp. of the central nervous system

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Abstract

Case description

A 38-year-old man presented with headaches and generalized weakness. He was found to have AIDS; a ring-enhancing central nervous system lesion was found on brain imaging and he had elevated serum Toxoplasma gondii IgG levels. A diagnosis of presumptive toxoplasma encephalitis was made and he received antiretrovirals and antitoxoplasma therapy for 4 years. Intermittent headaches and evidence of disease progression on neuroimaging warranted further evaluation and cerebrospinal fluid analysis revealed amebic forms on hematoxylin and eosin staining and positive polymerase chain reaction testing for Acanthamoeba spp. He was placed on miltefosine, fluconazole, trimethoprim-sulfamethoxazole and flucytosine for 7 months. Five months after therapy discontinuation he remains asymptomatic and is taking only antiretroviral therapy.

Conclusion

This is the first report of a patient with AIDS and granulomatous amebic encephalitis who survived with medical therapy only.

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References

  1. Marciano-Cabral F, Puffenbarger R, Cabral GA. The increasing importance of Acanthamoeba infections. J Eukaryot Microbiol. 2000;47:29–36.

    Article  CAS  PubMed  Google Scholar 

  2. Cabello-Vílchez AM, Martín-Navarro CM, López-Arencibia A, et al. Genotyping of potentially pathogenic Acanthamoeba strains isolated from nasal swabs of healthy individuals in Peru. Acta Trop. 2014;130:7–10.

    Article  PubMed  Google Scholar 

  3. Marciano-Cabral F, Cabral G. Acanthamoeba spp. as agents of disease in humans. Clin Microbiol Rev. 2003;16:273–307.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Seijo Martinez M, Gonzalez-Mediero G, Santiago P, Rodriguez De Lope A, Diz J, Conde C, Visvesvara GS. Granulomatous amebic encephalitis in a patient with AIDS: isolation of Acanthamoeba sp. Group II from brain tissue and successful treatment with sulfadiazine and fluconazole. J Clin Microbiol. 2000;38:3892–5.

    CAS  PubMed  PubMed Central  Google Scholar 

  5. Novati R, Castagna A, Morsica G, Vago L, Tambussi G, Ghezzi S, Gervasoni C, Bisson C, d’Arminio Monforte A, Lazzarin A. Polymerase chain reaction for Toxoplasma gondii DNA in the cerebrospinal fluid of AIDS patients with focal brain lesions. AIDS. 1994;8:1691–4.

    Article  CAS  PubMed  Google Scholar 

  6. Cinque P, Scarpellini P, Vago L, Linde A, Lazzarin A. Diagnosis of central nervous system complications in HIV-infected patients: cerebrospinal fluid analysis by the polymerase chain reaction. AIDS. 1997;11:1–17.

    Article  CAS  PubMed  Google Scholar 

  7. Mesquita RT, Ziegler AP, Hiramoto RM, Vidal JE, Pereira-Chioccola VL. Real-time quantitative PCR in cerebral toxoplasmosis diagnosis of Brazilian human immunodeficiency virus-infected patients. J Med Microbiol. 2010;59:641–7.

    Article  CAS  PubMed  Google Scholar 

  8. Pietrucha-Dilanchian P, Chan JC, Castellano-Sanchez A, Hirzel A, Laowansiri P, Tuda C, Visvesvara GS, Qvarnstrom Y, Ratzan KR. Balamuthia mandrillaris and Acanthamoeba amebic encephalitis with neurotoxoplasmosis coinfection in a patient with advanced HIV infection. J Clin Microbiol. 2012;50:1128–31.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Winiecka-Krusnell J, Dellacasa-Lindberg I, Dubey JP, Barragan A. Toxoplasma gondii: uptake and survival of oocysts in free-living amoebae. Exp Parasitol. 2009;121:124–31.

    Article  CAS  PubMed  Google Scholar 

  10. Singh P, Kochhar R, Vashishta RK, Khandelwal N, Prabhakar S, Mohindra S, Singhi P. Amebic meningoencephalitis: spectrum of imaging findings. AJNR Am J Neuroradiol. 2006;27:1217–21.

    CAS  PubMed  Google Scholar 

  11. Murakawa GJ, McCalmont T, Altman J, Telang GH, Hoffman MD, Kantor GR, Berger TG. Disseminated acanthamebiasis in patients with AIDS. A report of five cases and a review of the literature. Arch Dermatol. 1995;131:1291–6.

    Article  CAS  PubMed  Google Scholar 

  12. Sison JP, Kemper CA, Loveless M, McShane D, Visvesvara GS, Deresinski SC. Disseminated Acanthamoeba infection in patients with AIDS: case reports and review. Clin Infect Dis. 1995;20:1207–16.

    Article  CAS  PubMed  Google Scholar 

  13. Carter WW, Gompf SG, Toney JF, Greene JN, Cutolo EP. Disseminated Acanthamoeba sinusitis in a patient with AIDS: a possible role for early antiretroviral therapy. AIDS Read. 2004;14:41–9.

    PubMed  Google Scholar 

  14. Aichelburg AC, Walochnik J, Assadian O, Prosch H, Steuer A, Perneczky G, Visvesvara GS, Aspöck H, Vetter N. Successful treatment of disseminated Acanthamoeba sp. infection with miltefosine. Emerg Infect Dis. 2008;14:1743–6.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Cope JR, Roy SL, Yoder JS, Beach MJ. Increased patient survival: Miltefosine for treatment of free-living ameba infections caused by Acanthamoeba and Balamuthia. http://www.cste2.org/confpresentations/uploadfiles/cste%202013%20miltefosine%20poster%20final.pdf. Accessed on the 20 Jan 2017.

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Authors and Affiliations

  1. Department of Molecular Virology and Microbiology, Baylor College of Medicine, One Baylor Plaza, BCM-MS280, Houston, TX, 77030, USA

    Hana El Sahly

  2. Section of Infectious Diseases, Department of Medicine, Baylor College of Medicine, Houston, TX, USA

    Hana El Sahly, Michelle Udayamurthy & George Parkerson

  3. Section of Infectious Diseases, Department of Medicine, University of Texas Health Sciences Center, Houston, TX, USA

    Rodrigo Hasbun

Authors
  1. Hana El Sahly
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  2. Michelle Udayamurthy
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  3. George Parkerson
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  4. Rodrigo Hasbun
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Correspondence to Hana El Sahly.

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The authors report no conflict of interest pertaining to the content of this manuscript.

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El Sahly, H., Udayamurthy, M., Parkerson, G. et al. Survival of an AIDS patient after infection with Acanthamoeba sp. of the central nervous system. Infection 45, 715–718 (2017). https://doi.org/10.1007/s15010-017-1037-9

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  • DOI: https://doi.org/10.1007/s15010-017-1037-9

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