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Journal of Clinical Microbiology, October 2000, p. 3892-3895, Vol. 38, No. 10
0095-1137/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.

Granulomatous Amebic Encephalitis in a Patient with AIDS: Isolation of Acanthamoeba sp. Group II from Brain Tissue and Successful Treatment with Sulfadiazine and Fluconazole

M. Seijo Martinez,1,* G. Gonzalez-Mediero,2 P. Santiago,3 A. Rodriguez de Lope,4 J. Diz,5 C. Conde,4 and G. S. Visvesvara6

Departments of Neurology1 and Internal Medicine,5 Complexo Hospitalario de Pontevedra, and Departments of Microbiology,2 Pathology,3 and Neurosurgery,4 Hospital Xeral-Cies, Vigo, Spain, and Division of Parasitic Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia6

Received 4 February 2000/Returned for modification 23 March 2000/Accepted 23 June 2000

A patient with AIDS, treated with highly active antiretroviral therapy and trimethoprim-sulfamethoxazole, presented with confusion, a hemifield defect, and a mass lesion in the right occipital lobe. A brain biopsy confirmed granulomatous amebic encephalitis (GAE) due to Acanthamoeba castellanii. The patient was treated with fluconazole and sulfadiazine, and the lesion was surgically excised. This is the first case of AIDS-associated GAE responding favorably to therapy. The existence of a solitary brain lesion, absence of other sites of infection, and intense cellular response in spite of a very low CD4 count conditioned the favorable outcome. We review and discuss the diagnostic microbiologic options for the laboratory diagnosis of infections due to free-living amebae.

* Corresponding author. Mailing address: Neurology Service, Complexo Hospitalario de Pontevedra, Loureiro Crespo 2, Pontevedra Spain 36001. Phone: 34 986 800 000. Fax: 34 986 80 70 52. E-mail: mseijom{at}meditex.es.

Journal of Clinical Microbiology, October 2000, p. 3892-3895, Vol. 38, No. 10
0095-1137/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.


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