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Shobhana A, Saha B, Datta A, Trivedi S, Jha S, Bhowmik S, Banerjee K. Something Amiss: Acanthamoeba Meningoencephalitis: Report of Two Cases from Kolkata, India. Ann Indian Acad Neurol 2023; 26:789-792. [PMID: 38022465 PMCID: PMC10666860 DOI: 10.4103/aian.aian_621_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 08/16/2023] [Accepted: 08/18/2023] [Indexed: 12/01/2023] Open
Affiliation(s)
- A Shobhana
- Department Critical Care and Neurology, Tropical Medicine, Stroke Medicine, Institute of Neurosciences, Kolkata, West Bengal, India
| | - Bibhuti Saha
- Department of Infectious Diseases and Advanced Microbiology, Calcutta School of Tropical Medicine, Kolkata, West Bengal, India
| | - Ashis Datta
- Department of Neurology, Institute of Neurosciences, Kolkata, West Bengal, India
| | - Santosh Trivedi
- Department of Neurology, Institute of Neurosciences, Kolkata, West Bengal, India
| | - Shreyashi Jha
- Department of Neurology, Institute of Neurosciences, Kolkata, West Bengal, India
| | - Soumya Bhowmik
- Department of Neurology, Institute of Neurosciences, Kolkata, West Bengal, India
| | - Kokila Banerjee
- Department of Microbiology, Drs. Tribedi and Roy Diagnostic Laboratory, Kolkata, West Bengal, India
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2
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Keche A, Chakravarty S, Khatoon S, Kannauje P, Arora RD. Acanthamoeba species from a post-covid patient with CSF rhinorrhea; a next possible post covid menace? A case report. Indian J Med Microbiol 2022; 42:100-102. [PMID: 36244850 PMCID: PMC9561446 DOI: 10.1016/j.ijmmb.2022.09.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 09/28/2022] [Accepted: 09/30/2022] [Indexed: 11/19/2022]
Abstract
A case of Acanthamoeba rhinorrhea in a 32 years female, who was recently recovered from COVID-19 infectionat a tertiary care institute in India. Though, there was no standard treatment protocol for management of amoebic-meningo encephalitis. The patient was managed successfully with combination therapy of amphotericin B and miltefosine. Agents having trophicidal and cysticidal activities are used for treatment of CNS Acanthamoeba infection. COVID 19 infection, steroid therapy anddiabetes mellitus which lead to low immunitywere found to be associated contributing factors.
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Affiliation(s)
| | | | | | | | - Ripu Daman Arora
- Department of Otolaryngology & Head Neck Surgery, AIIMS Raipur, India.
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Concentrations of PGE2 and TXB2 in the Eyes of Mice with Disseminated Acanthamoebiasis. Pathogens 2022; 11:pathogens11040438. [PMID: 35456113 PMCID: PMC9025194 DOI: 10.3390/pathogens11040438] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 04/01/2022] [Accepted: 04/01/2022] [Indexed: 02/04/2023] Open
Abstract
Previous studies have shown that Acanthamoeba spp. may invade the eyes by migrating along the optic nerve to the eyes from the brain. This study aimed to confirm the presence of inflammation in the eyes of mice with disseminated acanthamoebiasis by examining prostaglandin E2 (PGE2) and thromboxane B2 (TXB2) concentrations in the eyes of immunocompetent and immunocompromised mice intranasally inoculated with Acanthamoeba spp. The PGE2 concentration was statistically significantly lower in the immunocompromised amoebae-infected mice on 8 dpi compared with the noninfected group of animals, and it was higher in the eyes of immunosuppressed amoebae-infected mice on 16 dpi than in the control group of animals. There was a statistically significant lower TXB2 concentration in the eyes of immunocompetent infected mice compared with the noninfected group on 8 dpi. However, on 24 dpi, we noted statistically significant higher TXB2 levels in the immunocompetent infected mice than in the control group. In immunocompromised mice, there was a lower TXB2 level on 8 dpi than in control mice. This study confirmed the existence of an inflammatory process in the eyes of immunocompetent and immunocompromised mice infected with Acanthamoeba spp. without damaged corneas.
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Aparicio DV, Bejarano JIC, de Los Santos AM, Ramírez-Cortinas S, de la O Cavazos M. Case Report: Granulomatous Amebic Encephalitis due to Acanthamoeba spp. in an Immunocompetent Pediatric Patient. Am J Trop Med Hyg 2021; 105:167-170. [PMID: 33970886 DOI: 10.4269/ajtmh.21-0129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 03/08/2021] [Indexed: 11/07/2022] Open
Abstract
Granulomatous amebic encephalitis (GAE) caused by Acanthamoeba is a rare infection with central nervous system (CNS) involvement usually with fatal consequences. Currently, information regarding GAE in children is scarce and is limited only to case reports and case series. A 13-year-old immunocompetent male patient with a 6-month history of progressive and intermittent headaches presented to our institution. One week before hospital admission, the patient showed signs of CNS involvement. Magnetic resonance imaging revealed multiple lesions with supra- and infratentorial cerebral abscesses. An empiric treatment with combined antibiotics was given, but the patient died after 20 days of hospital stay. A postmortem diagnosis confirmed GAE. Although it is a rare disease in pediatric patients, GAE should be considered in children with a chronic history of fever, headache, and vomiting with CNS involvement.
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Affiliation(s)
- Denisse Vaquera Aparicio
- 1Department of Pediatrics/Infectious Diseases Service, Hospital Universitario "Dr. José Eleuterio González," Universidad Autonoma de Nuevo Leon, Monterrey, Mexico
| | - José Iván Castillo Bejarano
- 1Department of Pediatrics/Infectious Diseases Service, Hospital Universitario "Dr. José Eleuterio González," Universidad Autonoma de Nuevo Leon, Monterrey, Mexico
| | - Abiel Mascareñas de Los Santos
- 1Department of Pediatrics/Infectious Diseases Service, Hospital Universitario "Dr. José Eleuterio González," Universidad Autonoma de Nuevo Leon, Monterrey, Mexico
| | - Sergio Ramírez-Cortinas
- 2Department of Pediatrics, Hospital Universitario "Dr. José Eleuterio González," Universidad Autonoma de Nuevo León, Monterrey, Mexico
| | - Manuel de la O Cavazos
- 2Department of Pediatrics, Hospital Universitario "Dr. José Eleuterio González," Universidad Autonoma de Nuevo León, Monterrey, Mexico
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Kulkarni G, R. Taallapalli A, Nashi S, Alladi S, Chickabasaviah Y. Granulomatous amebic encephalitis presenting like a tumor-chasing a diagnostic conundrum. Ann Indian Acad Neurol 2021; 24:968-970. [PMID: 35359565 PMCID: PMC8965954 DOI: 10.4103/aian.aian_994_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 10/11/2020] [Accepted: 11/03/2020] [Indexed: 11/23/2022] Open
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Das S, Gunasekaran K, Ajjampur SSR, Abraham D, George T, Janeela MA, Iyadurai R. Acanthamoeba encephalitis in immunocompetent hosts: A report of two cases. J Family Med Prim Care 2020; 9:1240-1243. [PMID: 32318505 PMCID: PMC7114032 DOI: 10.4103/jfmpc.jfmpc_1010_19] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 12/22/2019] [Accepted: 12/27/2019] [Indexed: 12/27/2022] Open
Abstract
Acanthamoeba are ubiquitous free-living amoeba. Acanthamoeba infections cause necrotizing vasculitis, resulting in vessel thrombosis and cerebral infarction. Acanthamoeba CNS infections, though uncommon, are associated with high mortality. Diagnosis is difficult and often delayed. Here, we present two immunocompetent hosts with Acanthamoeba encephalitis with good outcomes.
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Affiliation(s)
- Sohini Das
- Department of Medicine, Christian Medical College, Vellore, Tamil Nadu, India
| | - Karthik Gunasekaran
- Department of Medicine, Christian Medical College, Vellore, Tamil Nadu, India
| | - Sitara S R Ajjampur
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India
| | - Dilip Abraham
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India
| | - Tina George
- Department of Medicine, Christian Medical College, Vellore, Tamil Nadu, India
| | - M Asisha Janeela
- Department of Medicine, Christian Medical College, Vellore, Tamil Nadu, India
| | - Ramya Iyadurai
- Department of Medicine, Christian Medical College, Vellore, Tamil Nadu, India
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Kalra SK, Sharma P, Shyam K, Tejan N, Ghoshal U. Acanthamoeba and its pathogenic role in granulomatous amebic encephalitis. Exp Parasitol 2019; 208:107788. [PMID: 31647916 DOI: 10.1016/j.exppara.2019.107788] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 10/11/2019] [Accepted: 10/19/2019] [Indexed: 01/13/2023]
Abstract
Acanthamoeba is a free-living amoeba that is widely distributed in the environment. It is an opportunist protist, which is known to cause rare yet fatal infection of the central nervous system (CNS), granulomatous amebic encephalitis (GAE) in humans. GAE cases are increasingly been reported among immunocompromised patients, with few cases in immunocompetent hosts. Diagnosis of GAE primarily includes neuroimaging, microscopy, cerebrospinal fluid (CSF) culture, histopathology, serology and molecular techniques. Early diagnosis is vital for proper management of infected patients. Combination therapeutic approach has been tried in various GAE cases reported worldwide. We tried to present a comprehensive review, which summarizes on the epidemiology of GAE caused by Acanthamoeba along with the associated clinical symptoms, risk factors, diagnosis and treatment of GAE among infected patients.
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Affiliation(s)
- Sonali K Kalra
- Faculty of Applied Sciences and Biotechnology, Shoolini University of Biotechnology and Management Sciences, Bajhol, Distt. Solan, 173229, HP, India.
| | - Palvi Sharma
- Faculty of Applied Sciences and Biotechnology, Shoolini University of Biotechnology and Management Sciences, Bajhol, Distt. Solan, 173229, HP, India
| | - Kirti Shyam
- Faculty of Applied Sciences and Biotechnology, Shoolini University of Biotechnology and Management Sciences, Bajhol, Distt. Solan, 173229, HP, India
| | - Nidhi Tejan
- Department of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareili Road, Lucknow, 226014, UP, India
| | - Ujjala Ghoshal
- Department of Microbiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareili Road, Lucknow, 226014, UP, India
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Kot K, Kosik-Bogacka D, Łanocha-Arendarczyk N, Wojtkowiak-Giera A, Kolasa-Wołosiuk A. Expression of Toll-Like Receptors (TLR2 and TLR4) in the Eyes of Mice with Disseminated Acanthamoebiasis. BIOMED RESEARCH INTERNATIONAL 2019; 2019:1401894. [PMID: 31309100 PMCID: PMC6594330 DOI: 10.1155/2019/1401894] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 05/28/2019] [Indexed: 12/20/2022]
Abstract
Toll-like receptors (TLRs) play a key role in the innate immune response to numerous pathogens, including Acanthamoeba spp. The aim of this study was to determine the expression of TLR2 and TLR4 in the eyes of mice following intranasal infection with Acanthamoeba spp. in relation to the host's immunological status. Amoebae used in this study were isolated from the bronchial aspirate of a patient with acute myeloid leukemia (AML) and atypical symptoms of pneumonia. We found statistically significant differences in the expression of TLR2 and TLR4 in the eye of immunocompetent mice at 8, 16, and 24 days after Acanthamoeba spp. infection (dpi) compared to control group. Immunosuppressed mice showed significant differences in the expression of TLR2 at 16 and 24 dpi compared to uninfected animals. Our results indicate that TLR2 and TLR4 are upregulated in the eyes of mice in response to Acanthamoeba spp. We suggest that it is possible for trophozoites to migrate through the optic nerve from the brain to the eyes. The course of disseminated acanthamoebiasis may be influenced by the host's immunological status, and the observed changes in expression of TLR2 and TLR4 in the host's organs may indicate the role of these receptors in the pathomechanism of acanthamoebiasis.
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Affiliation(s)
- Karolina Kot
- Department of Biology and Medical Parasitology, Pomeranian Medical University in Szczecin, 70-204 Szczecin, Poland
| | - Danuta Kosik-Bogacka
- Independent of Pharmaceutical Botany, Department of Biology and Medical Parasitology, Pomeranian Medical University in Szczecin, 70-204 Szczecin, Poland
| | - Natalia Łanocha-Arendarczyk
- Department of Biology and Medical Parasitology, Pomeranian Medical University in Szczecin, 70-204 Szczecin, Poland
| | - Agnieszka Wojtkowiak-Giera
- Department of Biology and Medical Parasitology, Poznan University of Medical Sciences, Fredry 10, 61-701 Poznan, Poland
| | - Agnieszka Kolasa-Wołosiuk
- Department of Histology and Embryology, Pomeranian Medical University in Szczecin, 70-204 Szczecin, Poland
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Nehete LS, Kumar A, Chavali P, A. R. P, Devi BI. Fulminant acanthamoebic meningoencephalitis in immunocompetent patients: an uncommon entity. Br J Neurosurg 2018; 36:98-101. [DOI: 10.1080/02688697.2018.1485873] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Lokesh Suresh Nehete
- Department of Neurosurgery, National Institute of Mental Health and Neuro-Sciences, Bangalore, India
| | - Anil Kumar
- Department of Neurosurgery, National Institute of Mental Health and Neuro-Sciences, Bangalore, India
| | - Pooja Chavali
- Department of Neuropathology, National Institute of Mental Health and Neuro-Sciences, Bangalore, India
| | - Prabhuraj A. R.
- Department of Neurosurgery, National Institute of Mental Health and Neuro-Sciences, Bangalore, India
| | - Bhagavatula Indira Devi
- Department of Neurosurgery, National Institute of Mental Health and Neuro-Sciences, Bangalore, India
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Baron JM, Dighe AS, Flood JG. Case 3-2017: A Man with Cardiac Sarcoidosis and New Diplopia and Weakness. N Engl J Med 2017; 376:1897. [PMID: 28490000 DOI: 10.1056/nejmc1702199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Salameh A, Bello N, Becker J, Zangeneh T. Fatal Granulomatous Amoebic Encephalitis Caused by Acanthamoeba in a Patient With Kidney Transplant: A Case Report. Open Forum Infect Dis 2015; 2:ofv104. [PMID: 26280011 PMCID: PMC4534522 DOI: 10.1093/ofid/ofv104] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Accepted: 07/06/2015] [Indexed: 11/23/2022] Open
Abstract
Granulomatous amoebic encephalitis (GAE) due to Acanthamoeba is almost a uniformly fatal infection in immune-compromised hosts despite multidrug combination therapy. We report a case of GAE in a female who received a deceased donor kidney graft. She was treated with a combination of miltefosine, pentamidine, sulfadiazine, fluconazole, flucytosine, and azithromycin.
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Affiliation(s)
- Ahmad Salameh
- Division of Infectious Diseases, Department of Medicine
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