Department of Veterinary Science, The University of Melbourne, Werribee, VIC, Australia.
Parasitol Res. 2011 Apr;108(4):1069-73. doi: 10.1007/s00436-010-2197-z. Epub 2010 Dec 14.
A case of granulomatous amoebic meningoencephalitis in a previously healthy, mature, apparently immunocompetent dog, with a history of exposure to stagnant water, is reported. The case presented with ataxia and a tendency to fall to the left side. A computed tomography (CT) showed a ring-enhancing lesion within the cerebellum; an examination of cerebrospinal fluid (CSF) revealed nonspecific mixed-cell pleocytosis. Despite antibiotic and anti-inflammatory therapy, clinical signs progressed rapidly to decerebellate rigidity over 4 days, and the dog was euthanased. Significant post-mortem findings were restricted to the brain, with a localised lytic lesion in the deep cerebellar white matter. Histopathological examination of the brain showed focally extensive cavitation of the white matter and communication of the lesion with the fourth ventricle. The affected area contained structures consistent with amoebae and was infiltrated by neutrophils mixed with lower numbers of macrophages, plasma cells and lymphocytes. The amoebae were identified as Balamuthia mandrillaris, based on specific immunofluorescence detection. Amoebic meningoencephalitis should be considered in dogs with evidence of focal cavitary lesions in the brain, particularly in cases with a history of swimming in stagnant water.
报道了一例先前健康、成熟、明显免疫功能正常的犬发生肉芽肿性阿米巴脑膜脑炎。该病例表现为共济失调和倾向于向左侧跌倒。计算机断层扫描（CT）显示小脑内有环形增强病变；脑脊液（CSF）检查显示非特异性混合细胞增多症。尽管进行了抗生素和抗炎治疗，但临床症状在 4 天内迅速进展为去小脑强直，随后对该犬实施安乐死。尸检的重要发现仅限于大脑，在深部小脑白质有局部溶骨性病变。脑的组织病理学检查显示白质广泛局限性空洞化，病变与第四脑室相通。受影响的区域包含与阿米巴虫一致的结构，并被中性粒细胞浸润，混合有较少数量的巨噬细胞、浆细胞和淋巴细胞。通过特异性免疫荧光检测，确定这些阿米巴虫为曼氏巴贝虫。对于有脑内局灶性空洞病变证据的犬，特别是有在死水游泳史的犬，应考虑阿米巴脑膜脑炎。
