Oddó B David, Ciani A Susana, Vial C Pablo
Departamento de Anatomía Patológica, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
Rev Chilena Infectol. 2006 Sep;23(3):232-6. Epub 2006 Aug 4.
The case of a 7 month-old baby boy is presented, with a history of several weeks of evolution of personality changes, convulsions and fever. While he was hospitalized, the brain image study showed multifocal cavity lesions, which varied from millimeters to 4 cm of diameter, not producing mass effect. Their biopsy revealed necrotizing encephalitis. In spite of treatment, the lesions progressed and the boy died. The autopsy demonstrated an extensive necrotizing encephalitis with fibrinoid necrotic arteritis, signs of organization, and the presence of parasitic elements with characteristics of trophozoites and cysts of free-living amoebas belonging to the genus Acanthamoeba or Balamuthia. In addition, hypoplasia-dysplasia of the thymus and signs of shock were found. The morphologic elements correspond to the disease described as granulomatous amebic encephalitis and the agent found was identified as Balamuthia mandrillaris (Centers for Diseases Control and Prevention, Atlanta, USA ).
本文报告了一名7个月大男婴的病例,其有几周性格改变、惊厥和发热的病史。住院期间,脑部影像检查显示多灶性空洞病变,直径从几毫米到4厘米不等,未产生占位效应。活检显示为坏死性脑炎。尽管进行了治疗,病变仍进展,男孩最终死亡。尸检显示广泛的坏死性脑炎,伴有纤维蛋白样坏死性动脉炎、机化迹象,以及具有滋养体和自由生活阿米巴囊肿特征的寄生虫成分,这些阿米巴属于棘阿米巴属或巴拉姆希阿米巴属。此外,还发现了胸腺发育不全-发育异常和休克迹象。形态学表现符合肉芽肿性阿米巴脑炎的描述,所发现的病原体被鉴定为曼氏巴拉姆希阿米巴(美国亚特兰大疾病控制与预防中心)。