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Case Reports
. 2014 Jan;17(1):108-12.
doi: 10.4103/0972-2327.128571.

Acanthamoeba meningoencephalitis

S R Chandra  1 , Sikandar Adwani  2 , Anitha Mahadevan  3
Affiliations
Case Reports

Acanthamoeba meningoencephalitis

S R Chandra et al. Ann Indian Acad Neurol. 2014 Jan.

Abstract

Report of a case of young immunocompetent male adult with autopsy proven acanthamoeba meningoencephalitis. The patient presented with a protracted febrile illness of 3 months duration with features of meningoencephalitis, this was followed by rapid deterioration while on anti tuberculous therapy and steroids and ended fatally. His magnetic resonance imaging showed features of hemorrhagic meningoencephalitis and magnetic resonance spectroscopy showed choline peak. Autopsy revealed necrotizing meningoencephalitis and intraocular colonization due to acanthamoeba.

Keywords: Acanthamoeba meningoencephalitis; immunocompetent; intraocular colonization; magnetic resonance imaging; magnetic resonance spectroscopy.

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Conflict of interest statement

Conflict of Interest: Nil

Figures

Figure 1
Figure 1
Left putamen and thalamus showing hemorrhagic lesions with features of leptomeningitis
Figure 2
Figure 2
Multivoxel short TE MRS reveals raised choline (cho/cr-3) and lipid lactate with reduced NAA. DWI demonstrates acute infarct in left caudate head and anterior lentiform nucleus indicating occlusion of recurrent artery of Heubner due to arteritis
Figure 3
Figure 3
Large coalescing necrotizing hemorrhagic lesions are seen involving the insular cortex and putamen with extensive perilesional edema with compression of ipsilateral ventricle (a) on histology, dense vasculitis and inflammation is noted (b) large trophozoite forms with prominent nucleoli (c) is seen aggregating around vessels in addition to thick walled cyst forms of acanthamoeba (d)
Figure 4
Figure 4
Dot blot hybridization of PCR product shows positivity in serum, brain tissue and left vitreous samples tested (arrows). The CSF and right vitreous was negative (IC: Internal positive control included in each)
See this image and copyright information in PMC

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