Acanthamoeba infection in an interhemispheric ependymal cyst: a case report

Ranjan, Rakesh; Handa, Amit; Choudhary, Ajay; Kumar, Sushil

doi:10.1016/j.surneu.2008.04.008

Cited by 13 publications

(10 citation statements)

References 10 publications

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“…Acanthamoeba and Balamuthia species cause granulomatous amebic encephalitis usually in immunocompromised patients, including those receiving monoclonal antibody therapy, but may rarely occur in immunocompetent hosts (99)(100)(101)(102). Disseminated granulomatous amebic disease and amebic keratitis are other forms of the disease (100).…”

Section: Granulomatous Amebic Encephalitismentioning

confidence: 99%

“…Disseminated granulomatous amebic disease and amebic keratitis are other forms of the disease (100).…”

Section: Granulomatous Amebic Encephalitismentioning

confidence: 99%

“…The clinical manifestation of Acanthamoeba histolytica infection is typically subacute to chronic encephalitis, commonly with headache, altered mental status, and focal neurologic deficits (100).…”

Section: Granulomatous Amebic Encephalitismentioning

confidence: 99%

“…Diagnosis of Acanthamoeba infection can be established through a variety of tests, including identification of trophozoites with "spikey" pseudopodia on wet mount and Giemsa stains of CSF samples and positive polymerase chain reaction test results (100). An overwhelming majority of affected patients die of the disease, with only a few survivors reported in the literature (100,(110)(111)(112).…”

Section: Granulomatous Amebic Encephalitismentioning

confidence: 99%

“…An overwhelming majority of affected patients die of the disease, with only a few survivors reported in the literature (100,(110)(111)(112). No definitive therapy has been reported in the literature, although combination antibiotic, antifungal, and antihelminthic treatment (typically rifampicin, fluconazole, and trimethoprim-sulfamethoxazole) is commonly given (100). Despite aggressive therapy, death is common within 7-10 days after onset of illness (100).…”

Section: Granulomatous Amebic Encephalitismentioning

confidence: 99%

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Bacterial, Fungal, and Parasitic Infections of the Central Nervous System: Radiologic-Pathologic Correlation and Historical Perspectives:From the Radiologic Pathology Archives

Shih¹,

Koeller²

2015

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Despite remarkable progress in prevention and treatment, infectious diseases affecting the central nervous system remain an important source of morbidity and mortality, particularly in less-developed countries and in immunocompromised persons. Bacterial, fungal, and parasitic pathogens are derived from living organisms and affect the brain, spinal cord, or meninges. Infections due to these pathogens are associated with a variety of neuroimaging patterns that can be appreciated at magnetic resonance imaging in most cases. Bacterial infections, most often due to Streptococcus, Haemophilus, and Neisseria species, cause significant meningitis, whereas the less common cerebritis and subsequent abscess formation have well-documented progression, with increasingly prominent altered signal intensity and corresponding contrast enhancement. Atypical bacterial infections are characterized by the development of a granulomatous response, classically seen in tuberculosis, in which the tuberculoma is the most common parenchymal form of the disease; spirochetal and rickettsial diseases are less common. Fungal infections predominate in immunocompromised hosts and are caused by yeasts, molds, and dimorphic fungi. Cryptococcal meningitis is the most common fungal infection, whereas candidiasis is the most common nosocomial infection. Mucormycosis and aspergillosis are characterized by angioinvasiveness and are associated with high morbidity and mortality among immunocompromised patients. In terms of potential exposure in the worldwide population, parasitic infections, including neurocysticercosis, toxoplasmosis, echinococcosis, malaria, and schistosomiasis, are the greatest threat. Rare amebic infections are noteworthy for their extreme virulence and high mortality. The objective of this article is to highlight the characteristic neuroimaging manifestations of bacterial, fungal, and parasitic diseases, with emphasis on radiologic-pathologic correlation and historical perspectives.

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Section: Granulomatous Amebic Encephalitismentioning

confidence: 99%

“…Disseminated granulomatous amebic disease and amebic keratitis are other forms of the disease (100).…”

Section: Granulomatous Amebic Encephalitismentioning

confidence: 99%

Section: Granulomatous Amebic Encephalitismentioning

confidence: 99%

Section: Granulomatous Amebic Encephalitismentioning

confidence: 99%

Section: Granulomatous Amebic Encephalitismentioning

confidence: 99%

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Bacterial, Fungal, and Parasitic Infections of the Central Nervous System: Radiologic-Pathologic Correlation and Historical Perspectives:From the Radiologic Pathology Archives

Shih¹,

Koeller²

2015

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120

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Supratentorial neurenteric cyst with spontaneous repetitive intracystic hemorrhage mimicking brain abscess: a case report

et al. 2013

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Neurenteric cyst (NC) is a benign epithelial cyst (BEC) of endodermal origin that mostly occurs in the spinal subdural space or posterior cranial fossa. A 28-year-old male presented with a left frontal lobe NC associated with spontaneous repetitive intracystic hemorrhage, which was initially diagnosed and treated as a brain abscess. He presented with headache and disorientation, without underlying diseases. A cystic tumor was suspected because of a hypointense signal on diffusion-weighted magnetic resonance imaging (MRI). One day after admission, his condition deteriorated rapidly and emergency cyst aspiration was performed. A brown viscous liquid like bloody pus comprising many neutrophils and macrophages was obtained. Although culture was negative, we initially started antibiotic treatment because of cyst content characteristics and rapid clinical course compatible with brain abscess. He was discharged without neurological deficits, but occasionally complained of intense headache. Computed tomography/MRI showed repetitive intracystic hemorrhage and gradual re-enlargement of the lesion. He underwent radical cyst excision by frontal craniotomy 34 months after aspiration. The pathological diagnosis was NC. We believe this is the first report of a supratentorial NC with spontaneous repetitive intracystic hemorrhage. BECs, especially with intracystic hemorrhage, are difficult to be distinguished from brain abscesses. In cases of cystic lesions or presumed brain abscesses refractory to treatment with aspiration and/or antibiotics, BECs should be considered, and radical cyst wall removal should be considered a treatment option.

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