title: Acanthamoeba Infection in a Drowning Child.
abstract: BACKGROUND
  Acanthamoeba infection is a potential life-threatening complication of drowning. The management of drowning-associated Acanthamoeba infection remains controversial. Survival reports on Acanthamoeba infection have been on case reports only.
  
  
  METHODS
  A 2-year-old, previously healthy Indonesian boy presented with decreased consciousness and inadequate breathing, followingdrowning. The event was unsupervised with unknown estimated time of submersion. Resuscitation was commenced and mechanical ventilated was applied. Sputum specimen revealed alive Acanthamoeba with pseudopods and cysts. Sputum culture resulted in Pseudomonas aeruginosa and cerebrospinal fluid was supportive for Acanthamoeba with 1-3 trophozoites and cyst. Imaging of the head showed cerebral edema and encephalitis. The patient received intravenous ceftazidime, metronidazole, fluconazole and rifampicin. The patient's consciousness was unsatisfactory regained resulting in an altered mental status.
  
  
  CONCLUSIONS
  No treatment so far has given a succesful outcome for Acanthamoeba. In this case, management with metronidazole, rifampicin and fluconazole showed regain of consciousness resulting in altered mental status.
authors.affiliation: Pediatric Neurology, Department of Pediatrics, College of Medicine, Airlangga University, Surabaya, Indonesia.
authors.forename: Prastiya Indra
authors.initials: PI
authors.lastname: Gunawan
authors.affiliation: General Pediatrician, Department of Pediatrics, College of Medicine, Airlangga University, Surabaya, Indonesia.
authors.forename: Areta
authors.initials: A
authors.lastname: Idarto
authors.affiliation: Pediatric Neurology, Department of Pediatrics, College of Medicine, Airlangga University, Surabaya, Indonesia.
authors.forename: Darto
authors.initials: D
authors.lastname: Saharso
mesh_terms: D000048:Acanthamoeba; D000562:Amebiasis / Q000188:drug therapy / Q000209:etiology; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D002675:Child, Preschool; D003243:Consciousness; D003560:Cysts; D004332:Drowning; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000209:etiology; D011550:Pseudomonas aeruginosa; D053058:Trophozoites; D014474:Unconsciousness
chemical_list: D000890:Anti-Infective Agents
keywords: Acanthamoeba; Encephalitis; Pneumonia