Tan B, Weldon-Linne C M, Rhone D P, Penning C L, Visvesvara G S
Department of Pathology, University of Illinois Metropolitan Group Hospitals, Chicago.
Arch Pathol Lab Med. 1993 Oct;117(10):1043-6.
Acanthamoeba organisms are a well-known, although rare, cause of central nervous system infection in immunodeficient hosts, including those with the acquired immunodeficiency syndrome. Extracerebral acanthamebiasis, with the exception of contact lens-associated keratitis, is reported but little emphasized in the literature. We describe two patients with the acquired immunodeficiency syndrome in whom skin lesions were the primary manifestations of Acanthamoeba infection. Central nervous system disease was proved in one patient and suspected, but unproved, in the other. The skin lesions exhibited an intact epidermis with suppurative inflammation of the subcutis, associated with numerous amebic cysts and trophozoites. The amebic cyst walls stained with periodic acid-Schiff and Gomori's methenamine-silver stains, creating confusion with Blastomyces dermatitidis yeast in one instance. Immunofluorescence studies and culture identified the organisms as an Acanthamoeba species. Preliminary studies in one of the cases suggested a previously undescribed Acanthamoeba species as the etiologic agent. Our experience emphasizes that skin lesions may be the presenting sign of disseminated Acanthamoeba infection in patients with the acquired immunodeficiency syndrome.
棘阿米巴原虫是免疫功能低下宿主（包括获得性免疫缺陷综合征患者）中枢神经系统感染的一个已知病因，尽管较为罕见。除了与隐形眼镜相关的角膜炎外，脑外棘阿米巴病虽有报道，但在文献中很少受到重视。我们描述了两名获得性免疫缺陷综合征患者，皮肤病变是棘阿米巴感染的主要表现。其中一名患者证实有中枢神经系统疾病，另一名患者疑似有中枢神经系统疾病但未经证实。皮肤病变表现为表皮完整，皮下有化脓性炎症，伴有大量阿米巴囊肿和滋养体。阿米巴囊肿壁经高碘酸 - 希夫染色和戈莫里六胺银染色后，有一例与皮炎芽生菌酵母产生混淆。免疫荧光研究和培养确定这些病原体为一种棘阿米巴属物种。其中一例的初步研究提示一种以前未描述过的棘阿米巴属物种为病原体。我们的经验强调，皮肤病变可能是获得性免疫缺陷综合征患者播散性棘阿米巴感染的首发体征。
