Fung Konrad Tang-Tat, Dhillon Amar Paul, McLaughlin James E, Lucas Sebastian B, Davidson Brian, Rolles Keith, Patch David, Burroughs Andrew K
Liver Transplantation and Hepatobiliary Medicine, Royal Free Hospital, London, United Kingdom.
Liver Transpl. 2008 Mar;14(3):308-12. doi: 10.1002/lt.21409.
Acanthamoeba-related cerebral abscess and encephalitis are rare but usually fatal, being caused by free-living amoebic infections usually occurring in immunocompromised patients. In patients receiving transplants, a literature review showed that the infection is universally fatal. The diagnosis is often missed despite appropriate investigations including lumbar puncture, computerized tomography, and brain biopsy. We present the first reported liver transplant patient with Acanthamoeba cerebral abscess. The diagnosis was made in brain tissue removed at decompressive frontal lobectomy. He was successfully treated with a 3-month course of co-trimoxazole and rifampicin. There was no recurrence of the disease after 11 years of follow-up.
棘阿米巴相关的脑脓肿和脑炎较为罕见，但通常是致命的，由自由生活的阿米巴感染引起，常见于免疫功能低下的患者。在接受移植的患者中，文献综述表明这种感染无一例外是致命的。尽管进行了包括腰椎穿刺、计算机断层扫描和脑活检在内的适当检查，诊断仍常常被漏诊。我们报告了首例有棘阿米巴脑脓肿的肝移植患者。诊断是在减压性额叶切除术中切除的脑组织中做出的。他接受了为期3个月的复方新诺明和利福平治疗并取得成功。随访11年后该病未复发。
