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H5N1 Influenza A Virus and Infected Human Plasma

2006; Centers for Disease Control and Prevention; Volume: 12; Issue: 6 Linguagem: Inglês

10.3201/eid1206.060227

1080-6059

Salin Chutinimitkul, Parvapan Bhattarakosol, Surangrat Srisuratanon, Atthapon Eiamudomkan, Kittipong Kongsomboon, Sudarat Damrongwatanapokin, Arunee Chaisingh, Kamol Suwannakarn, Thaweesak Chieochansin, Apiradee Theamboonlers, Yong Poovorawan,

Pneumonia and Respiratory Infections

We report a fatal case of encephalitis caused by Acanthamoeba in a 24-year-old woman from India with systemic lupus erythematosus.Diagnosis was made by identification of amebas in brain sections by immunofluorescence analysis and confirmed by demonstrating Acanthamoeba mitochondrial 16S rRNA gene DNA in brain tissue sections.A canthamoeba spp.are free-living amebae that cause granulomatous amebic encephalitis (GAE), most often in immunocompromised hosts, including HIV/AIDS and organ transplant patients and those receiving immunosuppressive medication (1).These organisms have also been associated with amebic keratitis, mainly in contact lens wearers, as well as with cutaneous, nasopharyngeal, and disseminated infections and amebic encephalitis.Amebic encephalitis results from the hematogenous spread of the amebae from the initial portals of entry (skin, respiratory system) to the brain parenchyma.GAE is found worldwide (1); it develops as a subclinical infection and is difficult to diagnose because of vague symptoms.It is usually identified in a biopsy specimen of brain lesions or during postmortem examination.Opportunistic infections are increasing because of HIV/AIDS, chemotherapeutic treatments, organ transplant procedures, and debilitating diseases.Although HIV/AIDS is under tenuous control in the industrialized world, it is a burgeoning public health crisis in the developing nations of Africa, Asia, and the Indian subcontinent.Amebic encephalitis cases likely are undetected in both industrialized and nonindustrialized nations.Acquainting clinicians with GAE is important so that they may include amebic encephalitis in differential diagnoses.We report a fatal case of Acanthamoeba encephalitis in a patient from India who was being treated for systemic lupus erythematosus with corticosteroids and methotrexate.