Department of Radiology, Eulji University Hospital, Eulji University College of Medicine, Daejeon, Korea.
Department of Neurosurgery, Eulji University Hospital, Eulji University College of Medicine, Daejeon, Korea.
Yonsei Med J. 2021 Jun;62(6):563-567. doi: 10.3349/ymj.2021.62.6.563.
Central nervous system infections caused by free-living amoeba are very rare, but often fatal. The typical image findings of amebic meningoencephalitis are non-specific, showing ring-like enhancement. We report the first case of fulminant disseminating fatal granulomatous amebic encephalitis caused by in an immunocompetent patient in South Korea. Our case exhibited two interesting features: one was the unusual clinical course and the other was additional image findings. Magnetic resonance imaging revealed a rim-enhancing lesion with intralesional blooming dark signal intensity on susceptibility weighted imaging and low signal intensity on diffusion weighted images and on apparent diffusion coefficient maps. Differential diagnosis was started from a tumor or non-tumorous lesion, and diagnosis was difficult due to the rarity of the disease. Following the clinical and diagnostic courses of our case, we recommend inspecting image findings of granulomatous amebic encephalitis for early diagnosis.
由自由生活阿米巴引起的中枢神经系统感染非常罕见，但往往是致命的。阿米巴脑膜脑炎的典型影像学发现是非特异性的，呈环状增强。我们报告了首例在韩国免疫功能正常的患者中由 引起的暴发性播散性致命性肉芽肿性阿米巴脑炎。我们的病例表现出两个有趣的特征：一是不寻常的临床过程，另一个是额外的图像发现。磁共振成像显示边缘增强病变，在磁敏感加权成像上显示腔内开花暗信号强度，在扩散加权图像和表观扩散系数图上显示低信号强度。鉴别诊断从肿瘤或非肿瘤病变开始，由于该病罕见，因此诊断困难。根据我们病例的临床和诊断过程，我们建议检查肉芽肿性阿米巴脑炎的图像发现，以进行早期诊断。
