Cure of Acanthamoeba cerebral abscess in a liver transplant patient.
Acanthamoeba-related cerebral abscess and encephalitis are rare but usually fatal, being caused by free-living amoebic infections usually occurring in immunocompromised patients. In patients receiving transplants, a literature review showed that the infection is universally fatal. The diagnosis is often missed despite appropriate investigations including lumbar puncture, computerized tomography, and brain biopsy. We present the first reported liver transplant patient with Acanthamoeba cerebral abscess. The diagnosis was made in brain tissue removed at decompressive frontal lobectomy. He was successfully treated with a 3-month course of co-trimoxazole and rifampicin. There was no recurrence of the disease after 11 years of follow-up.
Fung
Konrad Tang-Tat
KT
Liver Transplantation and Hepatobiliary Medicine, Royal Free Hospital, London, United Kingdom.
Dhillon
Amar Paul
AP
McLaughlin
James E
JE
Lucas
Sebastian B
SB
Davidson
Brian
B
Rolles
Keith
K
Patch
David
D
Burroughs
Andrew K
AK
D000048:Acanthamoeba / Q000276:immunology / Q000472:pathogenicity*; D000328:Adult; D000562:Amebiasis / Q000175:diagnosis / Q000473:pathology / Q000628:therapy*; D000818:Animals; D000962:Antimalarials / Q000627:therapeutic use*; D001922:Brain Abscess / Q000175:diagnosis / Q000473:pathology / Q000628:therapy*; D003131:Combined Modality Therapy; D004359:Drug Therapy, Combination; D005625:Frontal Lobe / Q000473:pathology / Q000601:surgery; D006801:Humans; D016867:Immunocompromised Host / Q000276:immunology; D007166:Immunosuppressive Agents / Q000276:immunology; D016031:Liver Transplantation / Q000276:immunology; D008297:Male; D009894:Opportunistic Infections / Q000175:diagnosis / Q000276:immunology / Q000628:therapy; D012293:Rifampin / Q000627:therapeutic use*; D016896:Treatment Outcome; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use*
D000962:Antimalarials; D007166:Immunosuppressive Agents; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D012293:Rifampin