Pritzker Adam S, Kim Bong K, Agrawal Dipti, Southern Paul M, Pandya Amit G
Department of Dermatology, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390-9190, USA.
J Am Acad Dermatol. 2004 Feb;50(2 Suppl):S38-41. doi: 10.1016/s0190-9622(03)02090-5.
Granulomatous amebic encephalitis is an uncommon central nervous system (CNS) infection, usually caused by Acanthamoeba spp., which generally occurs in immunocompromised individuals. Balamuthia mandrillaris is a recently described free-living ameba that occasionally causes fatal CNS disease. The infection might start from a minor, slowly progressive, skin ulceration that can be present for weeks to months before neurologic changes occur. The clinical and histologic presentation is easily confused with many other diseases. Accurate diagnosis requires an awareness of this unusual presentation of amebiasis and identification of the amebic trophozoites in tissue and culture. Special stains are helpful, but immunofluorescence assays or electron microscopy is required to identify the organism as B mandrillaris. We present a fatal case of granulomatous amebic encephalitis that began as a cutaneous infection in an immunocompetent host.
肉芽肿性阿米巴脑炎是一种罕见的中枢神经系统（CNS）感染，通常由棘阿米巴属引起，一般发生在免疫功能低下的个体中。曼氏巴贝斯虫是一种最近才被描述的自由生活阿米巴，偶尔会导致致命的中枢神经系统疾病。感染可能始于轻微的、缓慢进展的皮肤溃疡，在神经学改变出现之前，这种溃疡可能持续数周或数月。其临床和组织学表现很容易与许多其他疾病混淆。准确的诊断需要认识到这种不寻常的阿米巴病表现，并在组织和培养物中识别出阿米巴滋养体。特殊染色有助于诊断，但需要免疫荧光检测或电子显微镜来鉴定该病原体为曼氏巴贝斯虫。我们报告一例肉芽肿性阿米巴脑炎致死病例，该病例最初表现为免疫功能正常宿主的皮肤感染。
