Vollmer Michael Eric, Glaser Carol
Infectious Disease Doctors Medical Group, 365 Lennon Lane Suite 200 , Walnut Creek, CA 94598 , USA.
The Permanente Medical Group, Oakland Medical Center , 3505 Broadway St, Oakland, CA 94611 , USA.
JMM Case Rep. 2016 Jun 28;3(3):e005031. doi: 10.1099/jmmcr.0.005031. eCollection 2016 Jun.
This case report describes a human survivor of infection. This is a free-living amoeba that can cause infection with the devastating consequence of near universally fatal encephalitis. We report this case to demonstrate the possibility of recovery.
A 26-year-old Hispanic male, a landscape gardener, presented to the hospital in March 2010 with a two month history of headache, visual disturbances and new-onset seizures. Brain imaging identified two enhancing central lesions and was later identified by brain biopsy. He received several months of various antimicrobials including miltefosine, a novel use of the drug in this disease at the time. Seven weeks into therapy, considerations were made to switch him to 'comfort care' because of worsening clinical status and seemingly lack of response to treatment. The patient finally demonstrated clinical and radiological improvement after eight weeks with modified therapy, despite experiencing some debilitating toxic effects likely to be related to antibiotics. Two years after his initial presentation he made a complete recovery.
amoebic encephalitis is considered an almost universally fatal disease; this case demonstrates the possibility of recovery. This report outlines his treatment, drug toxicities and includes additional information regarding the therapeutic use of the drug miltefosine. Whether his survival is related to the specific antimicrobials used in this case is unknown and further investigation is warranted.
本病例报告描述了一名感染的人类幸存者。这是一种自由生活的变形虫，可导致感染，并引发几乎普遍致命的脑炎这一毁灭性后果。我们报告此病例以证明康复的可能性。
一名26岁的西班牙裔男性，景观园丁，于2010年3月因头痛、视力障碍和新发癫痫发作两个月的病史入院。脑部影像学检查发现两个强化的中央病变，后来通过脑活检确诊。他接受了数月的各种抗菌药物治疗，包括米替福新，这是当时该药物在这种疾病中的一种新用途。治疗七周后，由于临床状况恶化且似乎对治疗无反应，考虑将他转为“舒适护理”。尽管经历了一些可能与抗生素有关的使人衰弱的毒性作用，但患者在经过八周的改良治疗后最终显示出临床和影像学改善。在首次就诊两年后，他完全康复。
阿米巴性脑炎被认为是一种几乎普遍致命的疾病；本病例证明了康复的可能性。本报告概述了他的治疗、药物毒性，并包括有关米替福新药物治疗用途的其他信息。他的存活是否与本病例中使用的特定抗菌药物有关尚不清楚，有必要进行进一步调查。
