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免疫功能正常儿童由棘阿米巴引起的肉芽肿性阿米巴脑炎。

Granulomatous amebic encephalitis caused by Acanthamoeba in an immuncompetent child.

作者信息

Sütçü Murat, Aktürk Hacer, Gülümser-Şişko Sezen, Acar Manolya, Erol Oğuz Bülent, Somer Ayper, Bilgiç Bilge, Salman Nuran

机构信息

Division of Infectious Diseases, İstanbul University İstanbul Faculty of Medicine, İstanbul, Turkey.

Departments of Pediatrics, İstanbul University İstanbul Faculty of Medicine, İstanbul, Turkey.

出版信息

Turk J Pediatr. 2018;60(3):340-343. doi: 10.24953/turkjped.2018.03.019.

Abstract

Sütçü M, Aktürk H, Gülümser-Şişko S, Acar M, Erol OB, Somer A, Bilgiç B, Salman N. Granulomatous amebic encephalitis caused by Acanthamoeba in an immuncompetent child. Turk J Pediatr 2018; 60: 340-343. Acanthamoeba may lead to granulomatous amebic encephalitis (GAE) with high mortality rates generally in patients with immunosupression and/or chronic disease. Here, we present a rare GAE case, who was a previously healthy child. A Georgian 9 year old boy presented with focal seizure on his left arm and confusion. Since computed tomography (CT) demonstrated hypodense lesion on right occipital lobe, brain biopsy was performed. Histopathological examination of the biopsy material revealed Acanthamoeba cysts and trophozoites together with granulomatous inflammation. The patient, who had no clinical and laboratory findings consistent with immunedeficiency, was diagnosed as GAE. He was treated with a combination drug therapy. Even if it is very rare, amebic meningoencephalitis may also be seen in immunocompetent children, as in our case. Definitive diagnosis is made by microbiological and histopathological examination of brain biopsy material.

摘要

苏特丘·M、阿克图尔克·H、居吕姆塞尔 - 希斯科·S、阿恰尔·M、埃罗尔·OB、索默·A、比尔吉奇·B、萨尔曼·N。一名免疫功能正常儿童由棘阿米巴引起的肉芽肿性阿米巴脑炎。《土耳其儿科学杂志》2018年;60: 340 - 343。棘阿米巴通常在免疫抑制和/或患有慢性疾病的患者中可导致死亡率很高的肉芽肿性阿米巴脑炎(GAE)。在此,我们报告一例罕见的GAE病例,该病例为一名既往健康的儿童。一名9岁格鲁吉亚男孩出现左臂局灶性癫痫发作和意识模糊。由于计算机断层扫描(CT)显示右枕叶有低密度病变,遂进行了脑活检。活检材料的组织病理学检查发现棘阿米巴囊肿和滋养体以及肉芽肿性炎症。该患者没有与免疫缺陷相符的临床和实验室检查结果,被诊断为GAE。他接受了联合药物治疗。正如我们的病例所示,即使非常罕见,免疫功能正常的儿童也可能发生阿米巴脑膜脑炎。通过对脑活检材料进行微生物学和组织病理学检查做出明确诊断。

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