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Acute Granulomatous Acanthamoeba Encephalitis in an Immunocompetent Patient

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Abstract

Background

Acanthamoeba sp. are known to cause fatal granulomatous Acanthamoeba encephalitis (GAE) in immunocompromised patients.

Methods

The case of a 17 year old immunocompetent patient with acute purulent meningoencephalitis is reported.

Results

After substantial improvement of cerebrospinal fluid under conventional antimicrobial treatment the patient was suffering several relapses. The causative agent was identified as Acanthamoeba lenticulata T5 which entered the CNS through a bone dehiscence of ethmoidal cells. Due to severe vasospasm the patient developed multiple strokes, which led to marked neurologic sequels.

Conclusions

This case report demonstrates successful treatment of usually lethal GAE in an immunocompetent patient with high dose meropenem, linezolid, moxifloxacin and fluconazole followed by a partially adapted antimicrobial combination therapy.

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Authors and Affiliations

  1. Department of Neurology, Innsbruck Medical University, 6020 Innsbruck, Anichstrasse 35, Austria, Europe

    Peter Lackner, Ronny Beer, Gregor Broessner, Raimund Helbok, Bettina Pfausler, Christian Brenneis & Erich Schmutzhard

  2. Department of Medical Parasitology, Clinical Institute of Hygiene and Medical Microbiology, Medical University of Vienna, Vienna, Austria

    Herbert Auer & Julia Walochnik

Authors
  1. Peter Lackner
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  2. Ronny Beer
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  3. Gregor Broessner
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  4. Raimund Helbok
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  5. Bettina Pfausler
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  6. Christian Brenneis
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  7. Herbert Auer
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  8. Julia Walochnik
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  9. Erich Schmutzhard
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Corresponding author

Correspondence to Peter Lackner.

Additional information

Peter Lackner and Ronny Beer have contributed equally.

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Lackner, P., Beer, R., Broessner, G. et al. Acute Granulomatous Acanthamoeba Encephalitis in an Immunocompetent Patient. Neurocrit Care 12, 91–94 (2010). https://doi.org/10.1007/s12028-009-9291-z

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  • DOI: https://doi.org/10.1007/s12028-009-9291-z

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