[A clinico-pathological study of granulomatous amoebic encephalitis].
OBJECTIVE
To study the clinico-pathological characteristics and differential diagnosis of granulomatous meningioencephalitis caused by acanthamoeba.


METHODS
The clinical features, CT scan findings and post mortem pathological changes of 3 patients afflicted with granulomatous amoebic encephalitis (GAE) were analysed.


RESULTS
GAE is a chronic clinical entity. Clinical manifestations include headache, low fever, seizures, hemiparesis and coma leading to death. CSF: pressure slightly elevated with presence of lymphocytes and plasma cells, glucose usually low with moderately high protein levels. CT scans were non specific. Clinical course insidious and may mimic bacterial meningitis or tuberculous meningitis. Post mortem pathological examinations showed that acanthamoeba produced a chronic or subacute granulomatous meningioencephalitis. Acanthamoebic trophoziotes and cysts were found within the hemorrhagic necrotic cerebral tissues. In some cases there is severe angitis and fibrinoid necrosis of the vascular wall with perivascular cuffing by lymphocytes and plasma cells. Trophozoites and cysts were found within the perivascular space.


CONCLUSIONS
Acanthamoeba is an opportunistic pathogenic free living amoeba which can produce fatal GAE.
Lu
D
D
Department of Neuropathology, Xuanwu Hospital, Capital University of Medical Sciences, Beijing 100053.
Luo
L
L
Xu
Q
Q
Li
C
C
D000048:Acanthamoeba; D000293:Adolescent; D000328:Adult; D000562:Amebiasis / Q000150:complications* / Q000469:parasitology; D000818:Animals; D003937:Diagnosis, Differential; D004660:Encephalitis / Q000209:etiology / Q000473:pathology*; D017809:Fatal Outcome; D005260:Female; D006099:Granuloma / Q000209:etiology / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged