Rapidly fatal Acanthamoeba encephalitis and treatment of cryoglobulinemia.
We describe a 66-year-old woman with therapy-refractory cryoglobulinemia treated with rituximab, plasmapheresis, and steroids; a case of fatal meningoencephalitis caused by Acanthamoeba spp. then developed. Such infections are rare and show an unusually rapid course (possibly related to rituximab).
Meersseman
Wouter
W
Division of General Internal Medicine, Gasthuisberg University Hospital, Leuven, Belgium. wouter.meersseman@uz.kuleuven.ac.be
Lagrou
Katrien
K
Sciot
Raf
R
de Jonckheere
Johan
J
Haberler
Christine
C
Walochnik
Julia
J
Peetermans
Willy E
WE
van Wijngaerden
Eric
E
D000048:Acanthamoeba / Q000235:genetics / Q000302:isolation & purification*; D000368:Aged; D000562:Amebiasis / Q000209:etiology*; D000818:Animals; D000911:Antibodies, Monoclonal / Q000009:adverse effects / Q000627:therapeutic use*; D058846:Antibodies, Monoclonal, Murine-Derived; D001921:Brain / Q000469:parasitology; D003449:Cryoglobulinemia / Q000150:complications* / Q000628:therapy*; D016054:DNA, Protozoan / Q000032:analysis; D004275:DNA, Ribosomal / Q000032:analysis / Q000235:genetics; D004591:Electrophoresis, Polyacrylamide Gel; D017809:Fatal Outcome; D005260:Female; D006099:Granuloma / Q000175:diagnosis / Q000209:etiology* / Q000469:parasitology; D006801:Humans; D007150:Immunohistochemistry; D007155:Immunologic Factors / Q000009:adverse effects / Q000627:therapeutic use*; D008279:Magnetic Resonance Imaging; D008590:Meningoencephalitis / Q000209:etiology* / Q000469:parasitology; D010956:Plasmapheresis; D016133:Polymerase Chain Reaction; D000069283:Rituximab; D013194:Staining and Labeling; D013256:Steroids / Q000627:therapeutic use
D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D016054:DNA, Protozoan; D004275:DNA, Ribosomal; D007155:Immunologic Factors; D013256:Steroids; D000069283:Rituximab