Thamtam Vamshi Krishna, Uppin Megha S, Pyal Anjan, Kaul Subhash, Rani Jyostna Y, Sundaram C
Department of Pathology, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India.
Neurol India. 2016 Jan-Feb;64(1):101-4. doi: 10.4103/0028-3886.173662.
Granulomatous amoebic encephalitis (GAE) caused by certain species belonging to the genus Acanthamoeba, Balamuthia, or Naegleria presents as a subacute or chronic illness. Amoebic encephalitis caused by Acanthamoeba is seen more often in immunosuppressed individuals. Thus, it may often be associated with human immunodeficiency virus infection and acquired immune deficiency syndrome (HIV/AIDS), organ transplantation, administration of steroids and systemic lupus erythematosus (SLE). The clinical progression is rapid, most often leading on to mortality of the patients. The diagnosis in most of these patients is established on postmortem examination. We describe a case of fatal granulomatous amoebic encephalitis in a patient recently diagnosed to be having SLE, who was receiving corticosteroids, cyclophosphamide, methotrexate, and hydroxychloroquine. The patient presented in an altered sensorium and expired after being hospitalized for 6 days. Postmortem examination of the brain showed extensive areas of necrosis and neutrophilic infiltrate with trophozoites and cysts of Acanthamoeba.
由棘阿米巴属、巴拉姆希阿米巴属或耐格里属的某些物种引起的肉芽肿性阿米巴脑炎（GAE）表现为亚急性或慢性疾病。由棘阿米巴引起的阿米巴脑炎在免疫抑制个体中更为常见。因此，它常与人类免疫缺陷病毒感染和获得性免疫缺陷综合征（HIV/AIDS）、器官移植、类固醇给药以及系统性红斑狼疮（SLE）相关。临床进展迅速，多数情况下会导致患者死亡。这些患者中的大多数诊断是在尸检时确定的。我们描述了一例最近被诊断患有SLE的患者发生的致命性肉芽肿性阿米巴脑炎病例，该患者正在接受皮质类固醇、环磷酰胺、甲氨蝶呤和羟氯喹治疗。患者出现意识改变，住院6天后死亡。脑部尸检显示广泛的坏死区域以及伴有棘阿米巴滋养体和包囊的嗜中性粒细胞浸润。
