Case Report

Clinical Rheumatology

, Volume 17, Issue 4, pp 329-332

First online:

Granulomatous amoebic encephalitis caused byAcanthamoeba in a patient with systemic lupus erythematosus

  • J. KoideAffiliated withSecond Department of Internal Medicine, Saitama Medical Centre, Saitama Medical School, Saitama
  • , E. OkusawaAffiliated withDepartment of Parasitology, School of Medicine, Keio University
  • , T. ItoAffiliated withSecond Department of Internal Medicine, Saitama Medical Centre, Saitama Medical School, Saitama
  • , S. MoriAffiliated withSecond Department of Internal Medicine, Saitama Medical Centre, Saitama Medical School, Saitama
  • , T. TakeuchiAffiliated withSecond Department of Internal Medicine, Saitama Medical Centre, Saitama Medical School, Saitama
  • , S. ItoyamaAffiliated withDepartment of Pathology, Saitama Medical Centre, Saitama Medical School
  • , T. AbeAffiliated withSecond Department of Internal Medicine, Saitama Medical Centre, Saitama Medical School, Saitama

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Abstract

A 25-year-old chronically immunosuppressed woman with systemic lupus erythematosus (SLE) died after developing subacute granulomatous encephalitis caused byAcanthamoeba. Amoebic trophozoites were also found in the lung, suggesting a primary pulmonary focus of infection. The infectious encephalitis was difficult to differentiate from a flare-up of central nervous system lupus. This case illustrates thatAcanthamoeba can cause fatal encephalitis in lupus patients, as well as in patients with acquired immunodeficiency syndrome as previously reported. To our knowledge, this is the first reported case of granulomatous amoebic encephalitis due toAcanthamoeba in a patient with SLE.

Keywords

Acanthamoeba Granulomatous amoebic encephalitis Opportunistic Infection Systemic lupus erythematosus