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Fan W, Li P, Wei Q, Liu X, Cai Y, Li B, Lu Y. Metagenomic next-generation sequencing-assisted diagnosis of a rare case of primary cutaneous acanthamoebiasis in an HIV patient: a case report. Front Cell Infect Microbiol 2024; 14:1356095. [PMID: 38863830 PMCID: PMC11165212 DOI: 10.3389/fcimb.2024.1356095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 05/07/2024] [Indexed: 06/13/2024] Open
Abstract
Pathogenic and free-living Acanthamoeba are widely distributed in the environment and have been reported to cause keratitis and universally fatal encephalitis. Primary cutaneous acanthamoebiasis caused by Acanthamoeba is exceedingly rare and presents as isolated necrotic cutaneous lesions without involvement of the cornea or central nervous system. Cutaneous acanthamoebiasis often occurs in immunocompromised patients and is likely overlooked or even misdiagnosed only by cutaneous biopsy tissue histopathological analysis. Here, we report a HIV-infected 63-year-old female with oral leukoplakia for 4 months and scattered large skin ulcers all over the body for 2 months. The cause of the cutaneous lesions was unclear through cutaneous specimens histopathological analysis, and subsequently Acanthamoeba were detected by metagenomic next-generation sequencing (mNGS), which may be the cause of cutaneous lesions. Based on the mNGS results, a pathologist subsequently reviewed the previous pathological slides and found trophozoites of Acanthamoeba so that the cause was identified, and the skin ulcers improved significantly after treatment with multi-drug combination therapy. Acanthamoeba is also a host of pathogenic microorganisms. The presence of endosymbionts enhances the pathogenicity of Acanthamoeba, and no other pathogens were reported in this case. mNGS is helpful for rapidly diagnosing the etiology of rare skin diseases and can indicate the presence or absence of commensal microorganisms.
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Affiliation(s)
- Wei Fan
- Department of Pathology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Pin Li
- Research and Development Department, Sinopharm Medical Laboratory (Wuhan) Co., Ltd., Wuhan, China
| | - Qihao Wei
- Research and Development Department, Sinopharm Genomics Technology Co., Ltd., Wuhan, China
| | - Xinru Liu
- Research and Development Department, Sinopharm Medical Laboratory (Wuhan) Co., Ltd., Wuhan, China
| | - Yuxiang Cai
- Department of Pathology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Bin Li
- Research and Development Department, Sinopharm Genomics Technology Co., Ltd., Wuhan, China
| | - Yaping Lu
- Research and Development Department, Sinopharm Medical Laboratory (Wuhan) Co., Ltd., Wuhan, China
- Research and Development Department, Sinopharm Genomics Technology Co., Ltd., Wuhan, China
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Palackdkharry CS, Wottrich S, Dienes E, Bydon M, Steinmetz MP, Traynelis VC. The leptomeninges as a critical organ for normal CNS development and function: First patient and public involved systematic review of arachnoiditis (chronic meningitis). PLoS One 2022; 17:e0274634. [PMID: 36178925 PMCID: PMC9524710 DOI: 10.1371/journal.pone.0274634] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 08/31/2022] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND & IMPORTANCE This patient and public-involved systematic review originally focused on arachnoiditis, a supposedly rare "iatrogenic chronic meningitis" causing permanent neurologic damage and intractable pain. We sought to prove disease existence, causation, symptoms, and inform future directions. After 63 terms for the same pathology were found, the study was renamed Diseases of the Leptomeninges (DLMs). We present results that nullify traditional clinical thinking about DLMs, answer study questions, and create a unified path forward. METHODS The prospective PRISMA protocol is published at Arcsology.org. We used four platforms, 10 sources, extraction software, and critical review with ≥2 researchers at each phase. All human sources to 12/6/2020 were eligible for qualitative synthesis utilizing R. Weekly updates since cutoff strengthen conclusions. RESULTS Included were 887/14286 sources containing 12721 DLMs patients. Pathology involves the subarachnoid space (SAS) and pia. DLMs occurred in all countries as a contributor to the top 10 causes of disability-adjusted life years lost, with communicable diseases (CDs) predominating. In the USA, the ratio of CDs to iatrogenic causes is 2.4:1, contradicting arachnoiditis literature. Spinal fusion surgery comprised 54.7% of the iatrogenic category, with rhBMP-2 resulting in 2.4x more DLMs than no use (p<0.0001). Spinal injections and neuraxial anesthesia procedures cause 1.1%, and 0.2% permanent DLMs, respectively. Syringomyelia, hydrocephalus, and arachnoid cysts are complications caused by blocked CSF flow. CNS neuron death occurs due to insufficient arterial supply from compromised vasculature and nerves traversing the SAS. Contrast MRI is currently the diagnostic test of choice. Lack of radiologist recognition is problematic. DISCUSSION & CONCLUSION DLMs are common. The LM clinically functions as an organ with critical CNS-sustaining roles involving the SAS-pia structure, enclosed cells, lymphatics, and biologic pathways. Cases involve all specialties. Causes are numerous, symptoms predictable, and outcomes dependent on time to treatment and extent of residual SAS damage. An international disease classification and possible treatment trials are proposed.
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Affiliation(s)
| | - Stephanie Wottrich
- Case Western Reserve School of Medicine, Cleveland, Ohio, United States of America
| | - Erin Dienes
- Arcsology®, Mead, Colorado, United States of America
| | - Mohamad Bydon
- Department of Neurologic Surgery, Orthopedic Surgery, and Health Services Research, Mayo Clinic School of Medicine, Rochester, Minnesota, United States of America
| | - Michael P. Steinmetz
- Department of Neurological Surgery, Cleveland Clinic Lerner College of Medicine Neurologic Institute, Cleveland, Ohio, United States of America
| | - Vincent C. Traynelis
- Department of Neurosurgery, Rush University School of Medicine, Chicago, Illinois, United States of America
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Hu J, Zhang Y, Yu Y, Yu H, Guo S, Shi D, He J, Hu C, Yang J, Fang X, Xiao Y. Encephalomyelitis Caused by Balamuthia mandrillaris in a Woman With Breast Cancer: A Case Report and Review of the Literature. Front Immunol 2022; 12:768065. [PMID: 35069540 PMCID: PMC8766823 DOI: 10.3389/fimmu.2021.768065] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 12/10/2021] [Indexed: 11/13/2022] Open
Abstract
Balamuthia mandrillaris is one cause of a rare and severe brain infection called granulomatous amoebic encephalitis (GAE), which has a mortality rate of >90%. Diagnosis of Balamuthia GAE is difficult because symptoms are non-specific. Here, we report a case of Balamuthia amoebic encephalomyelitis (encephalitis and myelitis) in a woman with breast cancer. She sustained trauma near a garbage dump 2 years ago and subsequently developed a skin lesion with a Mycobacterium abscessus infection. She experienced dizziness, lethargy, nausea and vomiting, inability to walk, and deterioration of consciousness. Next-generation sequencing of cerebrospinal fluid (CSF) samples revealed B. mandrillaris, and MRI of both brain and spinal cord showed abnormal signals. T-cell receptor (TCR) sequencing of the CSF identified the Top1 TCR. A combination of amphotericin B, flucytosine, fluconazole, sulfamethoxazole, trimethoprim, clarithromycin, pentamidine, and miltefosine was administrated, but she deteriorated gradually and died on day 27 post-admission.
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Affiliation(s)
- Juan Hu
- Intensive Care Unit, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yiqi Zhang
- Intensive Care Unit, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yongwei Yu
- Intensive Care Unit, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Huili Yu
- Intensive Care Unit, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Siruo Guo
- Intensive Care Unit, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Ding Shi
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jianqin He
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Chi Hu
- Department of Neurosurgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jiqi Yang
- Department of Neurosurgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xueling Fang
- Intensive Care Unit, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yonghong Xiao
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
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Evaluation of Amebicidal and Cysticidal Activities of Antifungal Drug Isavuconazonium Sulfate against Acanthamoeba T4 Strains. Pharmaceuticals (Basel) 2021; 14:ph14121294. [PMID: 34959694 PMCID: PMC8707217 DOI: 10.3390/ph14121294] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 12/08/2021] [Accepted: 12/08/2021] [Indexed: 11/30/2022] Open
Abstract
Acanthamoeba species of amebae are often associated with Acanthamoeba keratitis, a severe corneal infection. Isavuconazonium sulfate is an FDA-approved drug for the treatment of invasive aspergillosis and mucormycosis. This prodrug is metabolized into the active isavuconazole moiety. Isavuconazole was previously identified to have amebicidal and cysticidal activity against Acanthamoeba T4 strains, but the activity of its prodrug, isavuconazonium sulfate, against trophozoites and cysts remains unknown. Since it is not known if isavuconazonium can be metabolized into isavuconazole in the human eye, we evaluated the activities of isavuconazonium sulfate against trophozoites and cysts of three T4 genotype strains of Acanthamoeba. Isavuconazonium displayed amebicidal activity at nanomolar concentrations as low as 1.4 nM and prevented excystation of cysts at concentrations as low as 136 μM. We also investigated the cysticidal activity of isavuconazonium sulfate in combination with a currently used amebicidal drug polyhexamethylene biguanide (PHMB). Although combination of isavuconazonium with PHMB did not elicit an obvious synergistic cysticidal activity, the combination did not cause an antagonistic effect on the cysts of Acanthamoeba T4 strains. Collectively, these findings suggest isavuconazonium retains potency against Acanthamoeba T4 strains and could be adapted for Acanthamoeba keratitis treatment.
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5
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Mungroo MR, Khan NA, Maciver S, Siddiqui R. Opportunistic free-living amoebal pathogens. Pathog Glob Health 2021; 116:70-84. [PMID: 34602025 DOI: 10.1080/20477724.2021.1985892] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Pathogenic free-living amoebae affecting the central nervous system are known to cause granulomatous amoebic encephalitis (GAE) or primary amoebic meningoencephalitis (PAM). Although hosts with impaired immunity are generally at a higher risk of severe disease, amoebae such as Naegleria fowleri and Balamuthia mandrillaris can instigate disease in otherwise immunocompetent individuals, whereas Acanthamoeba species mostly infect immunocompromised people. Acanthamoeba also cause a sight-threatening eye infection, mostly in contact lens wearers. Although infections due to pathogenic amoebae are considered rare, recently, these deadly amoebae were detected in water supplies in the USA. This is of particular concern, especially with global warming further exacerbating the problem. Herein, we describe the epidemiology, presentation, diagnosis, and management of free-living amoeba infections.
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Affiliation(s)
- Mohammad Ridwane Mungroo
- Department of Clinical Sciences, College of Medicine, University City, Sharjah, United Arab Emirates
| | - Naveed Ahmed Khan
- Department of Clinical Sciences, College of Medicine, University City, Sharjah, United Arab Emirates.,Research Institute of Health and Medical Sciences, University of Sharjah, Sharjah, UAE
| | - Sutherland Maciver
- Centre for Discovery Brain Sciences, Edinburgh Medical School: Biomedical Sciences, University of Edinburgh, Edinburgh, UK
| | - Ruqaiyyah Siddiqui
- College of Arts and Sciences, American University of Sharjah, Sharjah, UAE
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6
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Amebic Meningoencephalitis Mimicking Tubercular Meningitis. Indian J Pediatr 2021; 88:845-846. [PMID: 32897503 DOI: 10.1007/s12098-020-03476-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 08/17/2020] [Indexed: 10/23/2022]
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7
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Aparicio DV, Bejarano JIC, de Los Santos AM, Ramírez-Cortinas S, de la O Cavazos M. Case Report: Granulomatous Amebic Encephalitis due to Acanthamoeba spp. in an Immunocompetent Pediatric Patient. Am J Trop Med Hyg 2021; 105:167-170. [PMID: 33970886 DOI: 10.4269/ajtmh.21-0129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 03/08/2021] [Indexed: 11/07/2022] Open
Abstract
Granulomatous amebic encephalitis (GAE) caused by Acanthamoeba is a rare infection with central nervous system (CNS) involvement usually with fatal consequences. Currently, information regarding GAE in children is scarce and is limited only to case reports and case series. A 13-year-old immunocompetent male patient with a 6-month history of progressive and intermittent headaches presented to our institution. One week before hospital admission, the patient showed signs of CNS involvement. Magnetic resonance imaging revealed multiple lesions with supra- and infratentorial cerebral abscesses. An empiric treatment with combined antibiotics was given, but the patient died after 20 days of hospital stay. A postmortem diagnosis confirmed GAE. Although it is a rare disease in pediatric patients, GAE should be considered in children with a chronic history of fever, headache, and vomiting with CNS involvement.
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Affiliation(s)
- Denisse Vaquera Aparicio
- 1Department of Pediatrics/Infectious Diseases Service, Hospital Universitario "Dr. José Eleuterio González," Universidad Autonoma de Nuevo Leon, Monterrey, Mexico
| | - José Iván Castillo Bejarano
- 1Department of Pediatrics/Infectious Diseases Service, Hospital Universitario "Dr. José Eleuterio González," Universidad Autonoma de Nuevo Leon, Monterrey, Mexico
| | - Abiel Mascareñas de Los Santos
- 1Department of Pediatrics/Infectious Diseases Service, Hospital Universitario "Dr. José Eleuterio González," Universidad Autonoma de Nuevo Leon, Monterrey, Mexico
| | - Sergio Ramírez-Cortinas
- 2Department of Pediatrics, Hospital Universitario "Dr. José Eleuterio González," Universidad Autonoma de Nuevo León, Monterrey, Mexico
| | - Manuel de la O Cavazos
- 2Department of Pediatrics, Hospital Universitario "Dr. José Eleuterio González," Universidad Autonoma de Nuevo León, Monterrey, Mexico
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8
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Taravaud A, Fechtali-Moute Z, Loiseau PM, Pomel S. Drugs used for the treatment of cerebral and disseminated infections caused by free-living amoebae. Clin Transl Sci 2021; 14:791-805. [PMID: 33650319 PMCID: PMC8212752 DOI: 10.1111/cts.12955] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 11/25/2020] [Accepted: 11/25/2020] [Indexed: 01/29/2023] Open
Abstract
Free‐living amoebae (FLAs) are protozoa developing autonomously in diverse natural or artificial environments. The FLAs Acanthamoeba spp., Balamuthia mandrillaris, and Naegleria fowleri represent a risk for human health as they can become pathogenic and cause severe cerebral infections, named granulomatous amoebic encephalitis (GAE), Balamuthia amoebic encephalitis (BAE), and primary amoebic meningoencephalitis (PAM), respectively. Additionally, Acanthamoeba sp. can also rarely disseminate to diverse organs, such as the skin, sinuses, or bones, and cause extracerebral disseminated acanthamebiasis (EDA). No consensus treatment has been established for cerebral FLA infections or EDA. The therapy of cerebral and disseminated FLA infections often empirically associates a large diversity of drugs, all exhibiting a high toxicity. Nevertheless, these pathologies lead to a high mortality, above 90% of the cases, even in the presence of a treatment. In the present work, a total of 474 clinical cases of FLA infections gathered from the literature allowed to determine the frequency of usage, as well as the efficacy of the main drugs and drug combinations used in the treatment of these pathologies. The efficacy of drug usage was determined based on the survival rate after drug administration. The most efficient drugs, drug combinations, and their mechanism of action were discussed in regard to the present recommendations for the treatment of GAE, EDA, BAE, and PAM. At the end, this review aims to provide a useful tool for physicians in their choice to optimize the treatment of FLA infections.
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Affiliation(s)
- Alexandre Taravaud
- BioCIS, Université Paris-Sud, CNRS, Université Paris-Saclay, Châtenay-Malabry, France
| | - Zineb Fechtali-Moute
- BioCIS, Université Paris-Sud, CNRS, Université Paris-Saclay, Châtenay-Malabry, France
| | - Philippe M Loiseau
- BioCIS, Université Paris-Sud, CNRS, Université Paris-Saclay, Châtenay-Malabry, France
| | - Sébastien Pomel
- BioCIS, Université Paris-Sud, CNRS, Université Paris-Saclay, Châtenay-Malabry, France
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Kulkarni G, R. Taallapalli A, Nashi S, Alladi S, Chickabasaviah Y. Granulomatous amebic encephalitis presenting like a tumor-chasing a diagnostic conundrum. Ann Indian Acad Neurol 2021; 24:968-970. [PMID: 35359565 PMCID: PMC8965954 DOI: 10.4103/aian.aian_994_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 10/11/2020] [Accepted: 11/03/2020] [Indexed: 11/23/2022] Open
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10
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In Vitro Effect of Pitavastatin and Its Synergistic Activity with Isavuconazole against Acanthamoeba castellanii. Pathogens 2020; 9:pathogens9090681. [PMID: 32825652 PMCID: PMC7559540 DOI: 10.3390/pathogens9090681] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 08/18/2020] [Accepted: 08/19/2020] [Indexed: 02/06/2023] Open
Abstract
Acanthamoeba keratitis (AK) can occur in healthy individuals wearing contact lenses and it is a painful, blinding infection of the cornea caused by a free-living ameba Acanthamoeba. Current treatment for AK relies on a combination of chlorhexidine, propamidine isethionate, and polyhexamethylene biguanide. However, the current regimen includes an aggressive disinfectant and in 10% of cases recurrent infection ensues. Therefore, development of efficient and safe drugs is a critical unmet need to avert blindness. Acanthamoeba sterol biosynthesis includes two essential enzymes HMG-CoA reductase (HMGR) and sterol 14-demethylase (CYP51), and we earlier identified a CYP51 inhibitor isavuconazole that demonstrated nanomolar potency against A. castellanii trophozoites. In this study, we investigated the effect of well-tolerated HMGR inhibitors and identified pitavastatin that is active against trophozoites of three different clinical strains of A.castellanii. Pitavastatin demonstrated an EC50 of 0.5 to 1.9 µM, depending on strains. Combination of pitavastatin and isavuconazole is synergistic and led to 2- to 9-fold dose reduction for pitavastatin and 11- to 4000-fold dose reduction for isavuconazole to achieve 97% of growth inhibition. Pitavastatin, either alone or in combination with isavuconazole, may lead to repurposing for the treatment of Acanthamoeba keratitis.
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Fakae LB, Stevenson CW, Zhu XQ, Elsheikha HM. In vitro activity of Camellia sinensis (green tea) against trophozoites and cysts of Acanthamoeba castellanii. Int J Parasitol Drugs Drug Resist 2020; 13:59-72. [PMID: 32512260 PMCID: PMC7281304 DOI: 10.1016/j.ijpddr.2020.05.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 05/06/2020] [Accepted: 05/12/2020] [Indexed: 01/06/2023]
Abstract
The effect of Camellia sinensis (green tea) on the growth of Acanthamoeba castellanii trophozoites was examined using a microplate based-Sulforhodamine B (SRB) assay. C. sinensis hot and cold brews at 75% and 100% concentrations significantly inhibited the growth of trophozoites. We also examined the structural alterations in C. sinensis-treated trophozoites using transmission electron microscopy (TEM) and scanning electron microscopy (SEM). This analysis showed that C. sinensis compromised the cell membrane integrity and caused progressive destruction of trophozoites. C. sinensis also significantly inhibited the parasite's ability to form cysts in a dose-dependent manner and reduced the rate of excystation from cysts to trophozoites. C. sinensis exhibited low cytotoxic effects on primary corneal stromal cells. However, cytotoxicity was more pronounced in SV40-immortalized corneal epithelial cells. Chromatographic analysis showed that both hot and cold C. sinensis brews contained the same number and type of chemical compounds. This work demonstrated that C. sinensis has anti-acanthamoebic activity against trophozoite and cystic forms of A. castellanii. Further studies are warranted to identify the exact substances in C. sinensis that have the most potent anti-acanthamoebic effect.
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Affiliation(s)
- Lenu B Fakae
- School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington Campus, Loughborough, LE12 5RD, UK; School of Biosciences, University of Nottingham, Sutton Bonington Campus, Loughborough, LE12 5RD, UK; Rivers State University, Nkpolu - Oroworukwo P.M.B 5080, Port Harcourt, Rivers State, Nigeria
| | - Carl W Stevenson
- School of Biosciences, University of Nottingham, Sutton Bonington Campus, Loughborough, LE12 5RD, UK
| | - Xing-Quan Zhu
- State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Parasitology of Gansu Province, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, 730046, China
| | - Hany M Elsheikha
- School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington Campus, Loughborough, LE12 5RD, UK.
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12
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Mungroo MR, Anwar A, Khan NA, Siddiqui R. Brain-eating Amoebae Infection: Challenges and Opportunities in Chemotherapy. Mini Rev Med Chem 2019; 19:980-987. [PMID: 30868950 DOI: 10.2174/1389557519666190313161854] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 03/01/2019] [Accepted: 03/07/2019] [Indexed: 12/22/2022]
Abstract
Pathogenic free-living amoeba are known to cause a devastating infection of the central nervous system and are often referred to as "brain-eating amoebae". The mortality rate of more than 90% and free-living nature of these amoebae is a cause for concern. It is distressing that the mortality rate has remained the same over the past few decades, highlighting the lack of interest by the pharmaceutical industry. With the threat of global warming and increased outdoor activities of public, there is a need for renewed interest in identifying potential anti-amoebic compounds for successful prognosis. Here, we discuss the available chemotherapeutic options and opportunities for potential strategies in the treatment and diagnosis of these life-threatening infections.
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Affiliation(s)
- Mohammad Ridwane Mungroo
- Department of Biological Sciences, School of Science and Technology, Sunway University, Subang Jaya 47500, Selangor, Malaysia
| | - Ayaz Anwar
- Department of Biological Sciences, School of Science and Technology, Sunway University, Subang Jaya 47500, Selangor, Malaysia
| | - Naveed Ahmed Khan
- Department of Biological Sciences, School of Science and Technology, Sunway University, Subang Jaya 47500, Selangor, Malaysia
| | - Ruqaiyyah Siddiqui
- Department of Biological Sciences, School of Science and Technology, Sunway University, Subang Jaya 47500, Selangor, Malaysia
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13
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Gompf SG, Garcia C. Lethal encounters: The evolving spectrum of amoebic meningoencephalitis. IDCases 2019; 15:e00524. [PMID: 30937287 PMCID: PMC6430007 DOI: 10.1016/j.idcr.2019.e00524] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 03/08/2019] [Indexed: 11/21/2022] Open
Abstract
The free-living amoebae are thermophilic organisms that may play an increasing role among diseases of a warming world. They are uncommon, accidental, yet high consequence pathogens, with differing pathologic syndromes. New prospects for diagnosis and life-saving treatment make early disease recognition imperative. We review the three most commonly diagnosed species that infect humans: Naegleria fowleri, Acanthamoeba species, and Balamuthia mandrillaris.
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Affiliation(s)
- Sandra G. Gompf
- James A. Haley Veterans Hospital, 13000 Bruce B. Downs Blvd., 33612, Tampa, FL, United States
- University of South Florida Morsani College of Medicine, 12901 Bruce B. Downs Blvd., Tampa, FL 33612, United States
| | - Cristina Garcia
- James A. Haley Veterans Hospital, 13000 Bruce B. Downs Blvd., 33612, Tampa, FL, United States
- University of South Florida Morsani College of Medicine, 12901 Bruce B. Downs Blvd., Tampa, FL 33612, United States
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Gonçalves DDS, Ferreira MDS, Guimarães AJ. Extracellular Vesicles from the Protozoa Acanthamoeba castellanii: Their Role in Pathogenesis, Environmental Adaptation and Potential Applications. Bioengineering (Basel) 2019; 6:bioengineering6010013. [PMID: 30717103 PMCID: PMC6466093 DOI: 10.3390/bioengineering6010013] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 01/22/2019] [Accepted: 01/26/2019] [Indexed: 12/11/2022] Open
Abstract
Extracellular vesicles (EVs) are membranous compartments of distinct cellular origin and biogenesis, displaying different sizes and include exosomes, microvesicles, and apoptotic bodies. The EVs have been described in almost every living organism, from simple unicellular to higher evolutionary scale multicellular organisms, such as mammals. Several functions have been attributed to these structures, including roles in energy acquisition, cell-to-cell communication, gene expression modulation and pathogenesis. In this review, we described several aspects of the recently characterized EVs of the protozoa Acanthamoeba castellanii, a free-living amoeba (FLA) of emerging epidemiological importance, and compare their features to other parasites' EVs. These A. castellanii EVs are comprised of small microvesicles and exosomes and carry a wide range of molecules involved in many biological processes like cell signaling, carbohydrate metabolism and proteolytic activity, such as kinases, glucanases, and proteases, respectively. Several biomedical applications of these EVs have been proposed lately, including their use in vaccination, biofuel production, and the pharmaceutical industry, such as platforms for drug delivery.
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Affiliation(s)
- Diego de Souza Gonçalves
- Departamento de Microbiologia e Parasitologia, Instituto Biomédico, Universidade Federal Fluminense, Rio de Janeiro 24210-130, Brazil.
| | - Marina da Silva Ferreira
- Departamento de Imunologia, Instituto de Microbiologia Professor Paulo de Góes, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-970, Brazil.
| | - Allan J Guimarães
- Departamento de Microbiologia e Parasitologia, Instituto Biomédico, Universidade Federal Fluminense, Rio de Janeiro 24210-130, Brazil.
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Nehete LS, Kumar A, Chavali P, A. R. P, Devi BI. Fulminant acanthamoebic meningoencephalitis in immunocompetent patients: an uncommon entity. Br J Neurosurg 2018; 36:98-101. [DOI: 10.1080/02688697.2018.1485873] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Lokesh Suresh Nehete
- Department of Neurosurgery, National Institute of Mental Health and Neuro-Sciences, Bangalore, India
| | - Anil Kumar
- Department of Neurosurgery, National Institute of Mental Health and Neuro-Sciences, Bangalore, India
| | - Pooja Chavali
- Department of Neuropathology, National Institute of Mental Health and Neuro-Sciences, Bangalore, India
| | - Prabhuraj A. R.
- Department of Neurosurgery, National Institute of Mental Health and Neuro-Sciences, Bangalore, India
| | - Bhagavatula Indira Devi
- Department of Neurosurgery, National Institute of Mental Health and Neuro-Sciences, Bangalore, India
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16
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Geith S, Walochnik J, Prantl F, Sack S, Eyer F. Lethal outcome of granulomatous acanthamoebic encephalitis in a man who was human immunodeficiency virus-positive: a case report. J Med Case Rep 2018; 12:201. [PMID: 29996943 PMCID: PMC6042392 DOI: 10.1186/s13256-018-1734-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 06/03/2018] [Indexed: 11/15/2022] Open
Abstract
Background Acanthamoeba species can cause disseminating infections in immunocompromised individuals. Case presentation Here, we report a case of granulomatous acanthamoebic encephalitis with a lethal outcome in a 54-year-old German man who was human immunodeficiency virus-positive. The diagnosis was based on symptoms of progressive neurological deficits, including sensorimotor paralysis of his right leg and deteriorating alertness. Due to the rapid course and rather late diagnosis of the infection, effective treatment could not be applied and he died 12 days after hospital admission. Conclusions To the best of our knowledge, this is the second case of granulomatous acanthamoebic encephalitis reported within Germany. Our case highlights the importance of early diagnosis of granulomatous acanthamoebic encephalitis to prevent fatal outcome.
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Affiliation(s)
- Stefanie Geith
- Division of Clinical Toxicology & Poison Control Centre Munich, Department of Internal Medicine II, TUM School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany.
| | - Julia Walochnik
- Medical University of Vienna, Center for Pathophysiology, Infectiology and Immunology, Institute of Specific Prophylaxis and Tropical Medicine, Kinderspitalgasse 15, 1090, Vienna, Austria
| | - Franz Prantl
- Institute of Pathology, Academic Clinic Munich-Schwabing, Kölner Platz 1, 80804, Munich, Germany
| | - Stefan Sack
- Department of Cardiology, Pneumology and Internal Intensive Medicine, Academic Clinic Munich-Schwabing, Kölner Platz 1, 80804, Munich, Germany
| | - Florian Eyer
- Division of Clinical Toxicology & Poison Control Centre Munich, Department of Internal Medicine II, TUM School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675, Munich, Germany
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17
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Tang J, Zhu H, Cai L, Tang T, Tang J, Sun Y, Liu M, Dai K, Qiao Z, Yu C. Postoperative infection caused by Acinetobacter baumannii misdiagnosed as a free-living amoeba species in a humeral head hemiarthroplasty patient: a case report. Infect Dis Poverty 2018; 7:33. [PMID: 29631621 PMCID: PMC5890356 DOI: 10.1186/s40249-018-0408-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2017] [Accepted: 03/19/2018] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Acinetobacter baumannii is ubiquitous, facultative intracellular, and opportunistic bacterial pathogen. Its unique abilities allow it to survive in a diverse range of environments, including health care settings, leading to nosocomial infections. And its exceptional ability to develop resistance to multiple antibiotics leaves few drug options for treatment. It has been recognized as a leading cause of nosocomial pneumonia and bacteremia over the world. CASE PRESENTATION In this case, a 73-year-old woman presented with a Neer Group VI proximal humeral fracture. Six hours after a successfully performed hemiarthroplasty, she developed continuous fever. Clinical examination revealed that the vitals were regular. Laboratory and radiographic examinations revealed only elevated procalcitonin levels. Blood culture revealed no bacterial or fungal growth. Cooling treatment and empirical broad-spectrum antibiotic therapy showed no apparent effect. CONCLUSIONS We report a postoperative infection caused by Acinetobacter baumannii. The infectious pathogen was identified via molecular DNA sequencing and was initially misidentified as a free-living amoeba species upon microscopic examinations. The patient was mistreated with antiamebic combination therapy. Her symptoms persisted for over 4 months and were eventually followed by her death.
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Affiliation(s)
- Jiaxin Tang
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Huaimin Zhu
- Department of Microbiology and Parasitology, Second Military Medical University, Shanghai, 200433, China
| | - Li Cai
- Shanghai Municipal Center for Disease Control & Prevention, Shanghai, 200336, China
| | - Tingting Tang
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Jian Tang
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Yuehua Sun
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Ming Liu
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Kerong Dai
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Zhiguang Qiao
- Medical 3D Printing Innovation Research Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200125, China. .,Engineering Research Center of Digital Medicine and Clinical Translation, Ministry of Education, Shanghai, 200030, China.
| | - Chao Yu
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China.
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18
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Coven SL, Song E, Steward S, Pierson CR, Cope JR, Ali IK, Ardura MI, Hall MW, Chung MG, Bajwa RPS. Acanthamoeba granulomatous amoebic encephalitis after pediatric hematopoietic stem cell transplant. Pediatr Transplant 2017; 21. [PMID: 28921764 DOI: 10.1111/petr.13060] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/11/2017] [Indexed: 11/27/2022]
Abstract
Acanthamoeba encephalitis is a rare, often fatal condition, particularly after HSCT, with 9 reported cases to date in the world literature. Our case was originally diagnosed with ALL at age 3 years, and after several relapses underwent HSCT at age 9 years. At 17 years of age, he was diagnosed with secondary AML for which he underwent a second allogeneic HSCT. He presented with acute-onset worsening neurological deficits on day +226 after the second transplant and a post-mortem diagnosis of Acanthamoeba encephalitis was established, with the aid of the CDC.
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Affiliation(s)
- Scott L Coven
- Department of Pediatrics, Division of Hematology/Oncology/BMT, Nationwide Children's Hospital and The Ohio State University, Columbus, OH, USA
| | - Eunkyung Song
- Department of Pediatrics, Division of Infectious Diseases, Host Defense Program, Nationwide Children's Hospital and The Ohio State University, Columbus, OH, USA
| | - Sarah Steward
- Department of Pediatrics, Division of Critical Care, Nationwide Children's Hospital and The Ohio State University, Columbus, OH, USA
| | - Christopher R Pierson
- Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, OH, USA.,Department of Pathology and the Department of Biomedical Education and Anatomy, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Jennifer R Cope
- Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Ibne K Ali
- Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - Monica I Ardura
- Department of Pediatrics, Division of Infectious Diseases, Host Defense Program, Nationwide Children's Hospital and The Ohio State University, Columbus, OH, USA
| | - Mark W Hall
- Department of Pediatrics, Division of Critical Care, Nationwide Children's Hospital and The Ohio State University, Columbus, OH, USA
| | - Melissa G Chung
- Department of Pediatrics, Division of Critical Care, Nationwide Children's Hospital and The Ohio State University, Columbus, OH, USA.,Department of Pediatrics, Division of Neurology, Nationwide Children's Hospital and The Ohio State University, Columbus, OH, USA
| | - Rajinder P S Bajwa
- Department of Pediatrics, Division of Hematology/Oncology/BMT, Nationwide Children's Hospital and The Ohio State University, Columbus, OH, USA
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19
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Sharma M, Sudhan SS, Sharma S, Megha K, Nada R, Khurana S. Osteo-cutaneous acanthamoebiasis in a non-immunocompromised patient with a favorable outcome. Parasitol Int 2017; 66:727-730. [PMID: 28797593 DOI: 10.1016/j.parint.2017.08.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2017] [Revised: 08/02/2017] [Accepted: 08/06/2017] [Indexed: 11/26/2022]
Abstract
Osteo-cutaneous form is a rare presentation of acanthamoebiasis. We present the first such case from India in an apparently healthy male who developed cutaneous lesion with bone involvement after traumatic inoculation of Acanthamoeba cysts. The diagnosis was established by routine microbiological techniques and confirmed by 18SrRNA gene sequencing. Aggressive therapy with terbinafine, chlorhexidine, rifampicin and co-trimoxazole was successful in clearing the lesion and preventing encephalitis.
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Affiliation(s)
- Megha Sharma
- Department of Medical Parasitology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Shashi Sharma Sudhan
- Department of Microbiology, Government Medical College Hospital, Jammu, Jammu and Kashmir, India
| | - Sonali Sharma
- Department of Radiology, Government Medical College Hospital, Jammu, Jammu and Kashmir, India
| | - Kirti Megha
- Department of Medical Parasitology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Ritambhra Nada
- Department of Histopathology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Sumeeta Khurana
- Department of Medical Parasitology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
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20
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Cope JR, Yoder JS, Visvesvara GS. Protozoa. Infect Dis (Lond) 2017. [DOI: 10.1016/b978-0-7020-6285-8.00193-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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21
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In vivo CNS infection model of Acanthamoeba genotype T4: the early stages of infection lack presence of host inflammatory response and are a slow and contact-dependent process. Parasitol Res 2016; 116:725-733. [PMID: 27915418 DOI: 10.1007/s00436-016-5338-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Accepted: 11/22/2016] [Indexed: 10/20/2022]
Abstract
This study was developed in order to describe the early morphological events observed during the invasion of two pathogenic strains of Acanthamoeba (genotype T4); A. castellanii and A. culbertsoni, at the olfactory meatus and cerebral, pulmonary, renal, hepatic and splenic tissues levels, an in vivo invasion study. Histological and immunohistochemical description of the events at 24, 48, 72, and 96 h postintranasal inoculations of BALB/c mice was performed. A. castellanii showed a higher invasion rate than A. culbertsoni, which was only able to reach lung and brain tissue in the in vivo model. The current study supports previous evidence of lack of inflammatory response during the early stages of infection. Acanthamoeba invasion of the CNS and other organs is a slow and contact-dependent process. The early morphological events during the invasion of amoebae include the penetration of trophozoites into different epithelia: olfactory, respiratory, alveolar space, and renal tubule, which resemble the process of amoebae invasion described in corneal tissue. The data suggest that after reaching the nasal epithelium, trophozoites continued invasion, separating and lifting the most superficial cells, then migrating and penetrating between the cell junctions without causing a cytolytic effect on adjacent cells. These results reaffirm the idea that contact-dependent mechanisms are relevant for amoebae of Acanthamoeba genus regardless of the invasion site.
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22
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Abstract
For the past several decades, there has been little improvement in the morbidity and mortality associated with Acanthamoeba keratitis and Acanthamoeba encephalitis, respectively. The discovery of a plethora of antiacanthamoebic compounds has not yielded effective marketed chemotherapeutics. The rate of development of novel antiacanthamoebic chemotherapies of translational value and the lack of interest of the pharmaceutical industry in developing such chemotherapies have been disappointing. On the other hand, the market for contact lenses/contact lens disinfectants is a multi-billion-dollar industry and has been successful and profitable. A better understanding of drugs, their targets, and mechanisms of action will facilitate the development of more-effective chemotherapies. Here, we review the progress toward phenotypic drug discovery, emphasizing the shortcomings of useable therapies.
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23
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Behera HS, Satpathy G, Tripathi M. Isolation and genotyping of Acanthamoeba spp. from Acanthamoeba meningitis/ meningoencephalitis (AME) patients in India. Parasit Vectors 2016; 9:442. [PMID: 27507421 PMCID: PMC4977702 DOI: 10.1186/s13071-016-1729-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Accepted: 07/26/2016] [Indexed: 11/17/2022] Open
Abstract
Background Acanthamoeba spp. are free-living ubiquitous protozoans capable of causing Acanthamoeba meningitis/meningoencephalitis (AME) of the central nervous system in humans. Acanthamoeba spp. are divided into 20 different genotypes (T1–T20) on the basis of variation in nucleotide sequences of the 18S rRNA gene. The objective of this study was to identify the genotypes of Acanthamoeba spp. in patients of Acanthamoeba meningitis/meningoencephalitis (AME) using 18S rRNA gene-based PCR assay. The present study provides information regarding the involvement of the most prevalent and predominant genotype of Acanthamoeba spp. in Acanthamoeba meningitis/meningoencephalitis infections in India. Methods Cerebrospinal fluid (CSF) was collected from 149 clinically suspected Acanthamoeba meningitis/meningoencephalitis (AME) patients reporting to the outpatient department/causality services of the Neurosciences Centre, AIIMS, New Delhi, India during the past five years. Samples were inoculated onto 2 % non-nutrient agar plates overlaid with E. coli and incubated at 30 °C for 14 days. Among 149 suspected patients, ten were found culture-positive for Acanthamoeba spp. out of which six isolates were established in axenic culture for molecular analysis. DNA was isolated and a PCR assay was performed for amplification of the Diagnostic fragment 3 (DF3) (~280 bp) region of the 18S rRNA gene from axenic culture of six Acanthamoeba spp. isolates. Rns genotyping was performed on the basis of the variation in nucleotide sequences of DF3 region of the 18S rRNA gene. Results In the phylogenetic analysis, all of the six Acanthamoeba spp. isolates were found to belong to genotype T4. The sequence homology search for these six isolates in the NCBI databank showed homology with the available strains of Acanthamoeba spp. The newly generated sequences are available in the GenBank database under accession numbers KT004416–KT004421. Conclusions In the present study, genotype T4 was found as the most prevalent and predominant genotype in Acanthamoeba meningitis/ meningoencephalitis infections. Hence further studies are needed to develop optimal therapeutic strategy against Acanthamoeba spp. of genotype T4 to combat against the infections.
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Affiliation(s)
- Himanshu Sekhar Behera
- Ocular Microbiology, Dr. R. P. Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Gita Satpathy
- Ocular Microbiology, Dr. R. P. Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, 110029, India.
| | - Manjari Tripathi
- Neurosciences Centre, All India Institute of Medical Sciences, New Delhi, 110029, India
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24
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Das S, Saha R, Rani M, Goyal R, Shah D, Asish JK. Central nervous system infection due to Acanthamoeba: A case series. Trop Parasitol 2016; 6:88-91. [PMID: 26998441 PMCID: PMC4778191 DOI: 10.4103/2229-5070.175130] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Affiliation(s)
- Shukla Das
- Department of Microbiology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi University, New Delhi, India E-mail:
| | - Rumpa Saha
- Department of Microbiology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi University, New Delhi, India E-mail:
| | - Mayuri Rani
- Department of Microbiology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi University, New Delhi, India E-mail:
| | - Ritika Goyal
- Department of Microbiology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi University, New Delhi, India E-mail:
| | - Dheeraj Shah
- Department of Pediatrics, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi University, New Delhi, India
| | - Jhajjar K Asish
- Department of Pediatrics, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi University, New Delhi, India
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25
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Shih RY, Koeller KK. Bacterial, Fungal, and Parasitic Infections of the Central Nervous System: Radiologic-Pathologic Correlation and Historical Perspectives. Radiographics 2015; 35:1141-69. [PMID: 26065933 DOI: 10.1148/rg.2015140317] [Citation(s) in RCA: 88] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Despite remarkable progress in prevention and treatment, infectious diseases affecting the central nervous system remain an important source of morbidity and mortality, particularly in less-developed countries and in immunocompromised persons. Bacterial, fungal, and parasitic pathogens are derived from living organisms and affect the brain, spinal cord, or meninges. Infections due to these pathogens are associated with a variety of neuroimaging patterns that can be appreciated at magnetic resonance imaging in most cases. Bacterial infections, most often due to Streptococcus, Haemophilus, and Neisseria species, cause significant meningitis, whereas the less common cerebritis and subsequent abscess formation have well-documented progression, with increasingly prominent altered signal intensity and corresponding contrast enhancement. Atypical bacterial infections are characterized by the development of a granulomatous response, classically seen in tuberculosis, in which the tuberculoma is the most common parenchymal form of the disease; spirochetal and rickettsial diseases are less common. Fungal infections predominate in immunocompromised hosts and are caused by yeasts, molds, and dimorphic fungi. Cryptococcal meningitis is the most common fungal infection, whereas candidiasis is the most common nosocomial infection. Mucormycosis and aspergillosis are characterized by angioinvasiveness and are associated with high morbidity and mortality among immunocompromised patients. In terms of potential exposure in the worldwide population, parasitic infections, including neurocysticercosis, toxoplasmosis, echinococcosis, malaria, and schistosomiasis, are the greatest threat. Rare amebic infections are noteworthy for their extreme virulence and high mortality. The objective of this article is to highlight the characteristic neuroimaging manifestations of bacterial, fungal, and parasitic diseases, with emphasis on radiologic-pathologic correlation and historical perspectives.
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Affiliation(s)
- Robert Y Shih
- From the Department of Neuroradiology, American Institute for Radiologic Pathology, 1010 Wayne Ave, Suite 320, Silver Spring, MD 20910 (R.Y.S., K.K.K.); Department of Radiology, Walter Reed National Military Medical Center, Bethesda, Md (R.Y.S.); and Department of Radiology, Mayo Clinic, Rochester, Minn (K.K.K.)
| | - Kelly K Koeller
- From the Department of Neuroradiology, American Institute for Radiologic Pathology, 1010 Wayne Ave, Suite 320, Silver Spring, MD 20910 (R.Y.S., K.K.K.); Department of Radiology, Walter Reed National Military Medical Center, Bethesda, Md (R.Y.S.); and Department of Radiology, Mayo Clinic, Rochester, Minn (K.K.K.)
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Khanna V, Shastri B, Anusha G, Mukhopadhayay C, Khanna R. Acanthamoeba meningoencephalitis in immunocompetent: A case report and review of literature. Trop Parasitol 2014; 4:115-8. [PMID: 25250233 PMCID: PMC4166796 DOI: 10.4103/2229-5070.138540] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2013] [Accepted: 08/12/2014] [Indexed: 11/29/2022] Open
Abstract
A 30-year-old manual laborer from Karnataka, India presented with intermittent low grade fever and diffuse headache for 1 month. On examination, patient had enlarged supraclavicular and cervical lymph nodes. Patient had positive Kernig's sign and neck stiffness. Motor, sensory and cranial nerve examinations were within the normal limits. Abdominal, cardiovascular and chest examination did not yield any positive findings. Contrast enhanced computed tomography head was normal. Patient was suspected to have extrapulmonary tuberculosis. Patient was started on antitubercular drugs. Diagnostic lumbar puncture was performed. Wet mount and Giemsa smear preparation of cerebrospinal fluid (CSF) showed trophozoites suggestive of Acanthamoeba. CSF was cultured onto non-nutrient agar with an overlay of Escherichia coli. Wet mount made from the culture media yielded cysts and trophozoites of Acanthamoeba spp. Patient was diagnosed with Acanthamoeba meningitis and was started on specific therapy with Rifampicin 600 mg once a day, Cotrimoxazole 960 mg twice-a-day and Fluconazole 400 mg once daily for 2 weeks. Patient had a complete recovery and was discharged from the hospital.
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Affiliation(s)
- Vinay Khanna
- Department of Microbiology, Kasturba Medical College, Manipal University, Manipal, Karnataka, India
| | - Ba Shastri
- Department of Medicine, Kasturba Medical College, Manipal University, Manipal, Karnataka, India
| | - G Anusha
- Department of Microbiology, Kasturba Medical College, Manipal University, Manipal, Karnataka, India
| | - Chiranjay Mukhopadhayay
- Department of Microbiology, Kasturba Medical College, Manipal University, Manipal, Karnataka, India
| | - Ruchee Khanna
- Department of Pathology, Kasturba Medical College, Manipal University, Manipal, Karnataka, India
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Zamora A, Henderson H, Swiatlo E. Acanthamoeba encephalitis: A Case Report and Review of Therapy. Surg Neurol Int 2014; 5:68. [PMID: 24991471 PMCID: PMC4078452 DOI: 10.4103/2152-7806.132239] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2014] [Accepted: 03/14/2014] [Indexed: 11/25/2022] Open
Abstract
Background: Acanthamoeba is a rare cause of encephalitis yet is associated with high mortality. Treatment protocols vary greatly and generally include combination therapy across a wide spectrum of antiinfective classes. Case Description: A 63-year-old male who underwent renal transplantation presented 6 months after transplantation with depressed level of consciousness. Imaging of the head with computerized tomography showed an enhancing lesion suspicious for brain abscess. Biopsy of the lesion showed Acanthamoeba cysts. The patient was treated with sulfadiazine, fluconazole, flucytosine, azithromycin, and miltefosine but without success. We review recently published cases of Acanthamoeba encephalitis with an emphasis on treatment protocols and outcomes. Conclusion: Free-living protozoans such as Acanthamoeba are ubiquitous in the environment and should be suspected in immunosuppressed persons who present with central nervous system findings and brain abscess. Biopsy is critical to establish the etiology so that appropriate combination therapy can be deployed.
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Affiliation(s)
- A Zamora
- Department of Medicine, University of Mississippi Medical Center, MS USA
| | - H Henderson
- Department of Medicine, University of Mississippi Medical Center, MS USA
| | - E Swiatlo
- Department of Medicine, University of Mississippi Medical Center, MS USA ; G.V. (Sonny) Montgomery VA Medical Center, Jackson, MS USA
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Satlin MJ, Graham JK, Visvesvara GS, Mena H, Marks KM, Saal SD, Soave R. Fulminant and fatal encephalitis caused by Acanthamoeba in a kidney transplant recipient: case report and literature review. Transpl Infect Dis 2013; 15:619-26. [PMID: 24010955 DOI: 10.1111/tid.12131] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Accepted: 05/27/2013] [Indexed: 11/28/2022]
Abstract
Acanthamoeba is the most common cause of granulomatous amebic encephalitis, a typically fatal condition that is classically described as indolent and slowly progressive. We report a case of Acanthamoeba encephalitis in a kidney transplant recipient that progressed to death within 3 days of symptom onset and was diagnosed at autopsy. We also review clinical characteristics, treatments, and outcomes of all published cases of Acanthamoeba encephalitis in solid organ transplant (SOT) recipients. Ten cases were identified, and the infection was fatal in 9 of these cases. In 6 patients, Acanthamoeba presented in a fulminant manner and death occurred within 2 weeks after the onset of neurologic symptoms. These acute presentations are likely related to immunodeficiencies associated with solid organ transplantation that result in an inability to control Acanthamoeba proliferation. Skin lesions may predate neurologic involvement and provide an opportunity for early diagnosis and treatment. Acanthamoeba is an under-recognized cause of encephalitis in SOT recipients and often presents in a fulminant manner in this population. Increased awareness of this disease and its clinical manifestations is essential to attain an early diagnosis and provide the best chance of cure.
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Affiliation(s)
- M J Satlin
- Division of Infectious Diseases, Department of Medicine, Weill Cornell Medical College, New York, New York, USA; Transplantation-Oncology Infectious Diseases Program, Department of Medicine, Weill Cornell Medical College, New York, New York, USA
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29
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Khurana S, Mewara A, Verma S, Totadri SK. Central nervous system infection with Acanthamoeba in a malnourished child. BMJ Case Rep 2012; 2012:bcr-2012-007449. [PMID: 23097578 DOI: 10.1136/bcr-2012-007449] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
A 3-year-old male child presented with moderate-to-high grade fever and non-projectile vomiting, generalised seizures and altered sensorium for 1 month. CT scan revealed a communicating hydrocephalus with no basal exudates. The microbiological tests were negative for Streptococcus pneumoniae, Haemophilus influenzae, Neisseria meningitides, brucellosis, cryptococcosis, HIV and Mycobacterium tuberculosis. Intracranial pressure was relieved by ventriculo-peritoneal shunt, and the child was empirically started on ceftriaxone, and antitubercular therapy with isoniazid, rifampicin, ethambutol and streptomycin, along with steroids and supportive treatment for seizures. The symptoms persisted. On further investigation the cerebrospinal fluid showed growth of Acanthamoeba spp., following which the initial treatment was stopped and a combination antiamoebic regimen of cotrimoxazole, rifampicin and ketoconazole was started, after which he showed clinical improvement. The treatment was continued for 6 months and on follow-up at 1, 3 and 6 months, there was a remarkable clinical improvement with no residual symptoms.
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Affiliation(s)
- Sumeeta Khurana
- Department of Parasitology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
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Webster D, Umar I, Umar I, Kolyvas G, Bilbao J, Guiot MC, Duplisea K, Qvarnstrom Y, Visvesvara GS. Treatment of granulomatous amoebic encephalitis with voriconazole and miltefosine in an immunocompetent soldier. Am J Trop Med Hyg 2012; 87:715-8. [PMID: 22869634 DOI: 10.4269/ajtmh.2012.12-0100] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
A 38-year-old male immunocompetent soldier developed generalized seizures. He underwent surgical debulking and a progressive demyelinating pseudotumor was identified. Serology and molecular testing confirmed a diagnosis of granulomatous amoebic encephalitis caused by Acanthamoeba sp. in this immunocompetent male. The patient was treated with oral voriconazole and miltefosine with Acanthamoeba titers returning to control levels and serial imaging demonstrating resolution of the residual lesion.
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Affiliation(s)
- Duncan Webster
- Department of Internal Medicine, Saint John Regional Hospital, Saint John, New Brunswick, Canada.
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31
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Goldberg E, Bishara J. Contemporary unconventional clinical use of co-trimoxazole. Clin Microbiol Infect 2012; 18:8-17. [DOI: 10.1111/j.1469-0691.2011.03613.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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32
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D'Auria A, Lin J, Geiseler PJ, Qvarnstrom Y, Bandea R, Roy S, Sriram R, Paddock C, Zaki S, Kim G, Visvesvara GS. Cutaneous Acanthamoebiasis with CNS Involvement Post-Transplantation: Implication for Differential Diagnosis of Skin Lesions in Immunocompromised Patients. ACTA ACUST UNITED AC 2012. [DOI: 10.4303/jnp/n120801] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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In vitro amoebicidal activities of Satureja cuneifolia and Melissa officinalis on Acanthamoeba castellanii cysts and trophozoites. Parasitol Res 2011; 110:2175-80. [PMID: 22160280 DOI: 10.1007/s00436-011-2744-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2011] [Accepted: 11/29/2011] [Indexed: 10/14/2022]
Abstract
Amoebic keratitis is difficult to treat without total efficacy in some patients because of cysts, which are less susceptible than trophozoites to the usual treatments. The aim of this study is to evaluate the in vitro amoebicidal activity of the methanolic extracts of Satureja cuneifolia and Melissa officinalis. In the presence of methanolic extracts (ranging from 1.0 to 32.0 mg/ml), numbers of the viable Acanthamoe castellanii trophozoites and cysts were decreased during the experimental process. Both extracts showed a time- and dose-dependent amoebicidal action on the trophozoites and cysts. Among the extracts tested, S. cuneifolia showed the strongest amoebicidal effect on the trophozoites and cysts. In the presence of 32 mg/ml extract, no viable trophozoites were observed within 24 h. At the same concentration value, the extract was found effective against the cysts at a rate of 46.3% within 72 h of the experimental process. At 16 mg/ml extract concentration, no viable trophozoites were also observed in the 24th hour of the experiment. At the end of the experimental process, 34.7% of the cysts were killed by the extract. M. officinalis showed moderate amoebicidal effect. At the concentration of 32 mg/ml, 44.3% and 30.0% of the trophozoites and cysts were killed by the extract, respectively. Results obtained from these concentration values were found statistically different in terms of their actions both on trophozoites and cysts (p<0.05).
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Reddy R, Vijayasaradhi M, Uppin MS, Challa S, Jabeen A, Borghain R. Acanthamoeba meningoencephalitis in an immunocompetent patient: an autopsy case report. Neuropathology 2011; 31:183-7. [PMID: 20667014 DOI: 10.1111/j.1440-1789.2010.01151.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Chronic granulomatous CNS infections may be caused by tuberculosis, fungi and rarely by free-living amoeba, especially in immunocompromised individuals. We report a rare, fatal case of granulomatous amoebic encephalitis in an immunocompetent patient mimicking CNS tuberculosis, and review the imageological features and diagnostic tests.
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Affiliation(s)
- Rajesh Reddy
- Department of Neurosurgery, Nizam's Institute of Medical Sciences, Hyderabad, India
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Polat ZA, Obwaller A, Vural A, Walochnik J. Efficacy of miltefosine for topical treatment of Acanthamoeba keratitis in Syrian hamsters. Parasitol Res 2011; 110:515-20. [DOI: 10.1007/s00436-011-2515-0] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2011] [Accepted: 06/22/2011] [Indexed: 10/18/2022]
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Abstract
Background: Amebic encephalitis (granulomatous amebic encephalitis, GAE) an extremely rare disease occurring in immunocompromised patients. Presentation and early imaging findings are nonspecific. In GAE, enhancement may or may not be seen on imaging studies despite the presence of an aggressive, necrotizing, parasitic infection. Case Description: The patient was a 79-year-old man with ill-defined autoimmune hepatitis. He was on mild immunosuppression with 6-MP and low-dose prednisone. He presented with an acute febrile illness and obtundation. Imaging revealed a nonenhancing mass lesion of the frontal lobe. The patient briefly improved on high-dose steroids, then deteriorated again, with repeat imaging showing enlargement of the edematous brain lesion and herniation. The patient underwent craniotomy for evacuation of a necrotic brain lesion. His condition did not improve. Frozen section revealed only necrosis. Permanent pathology revealed GAE caused by Acanthamoeba. Conclusion: Neurosurgeons should remain aware of this rare disease. Imaging is variable and may not show enhancement or necrosis despite large areas of parasitic infection.
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Affiliation(s)
- Peter L Mayer
- Department of Clinical Medicine, Florida State University, Florida, United States
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Affiliation(s)
- James H Diaz
- School of Public Health School of Medicine, Louisiana State University Health Sciences Center in New Orleans, New Orleans, LA 70112, USA.
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Akpek G, Uslu A, Huebner T, Taner A, Rapoport A, Gojo I, Akpolat Y, Ioffe O, Kleinberg M, Baer M. Granulomatous amebic encephalitis: an under-recognized cause of infectious mortality after hematopoietic stem cell transplantation. Transpl Infect Dis 2011; 13:366-73. [DOI: 10.1111/j.1399-3062.2011.00612.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Lorenzo-Morales J, Martín-Navarro CM, López-Arencibia A, Santana-Morales MA, Afonso-Lehmann RN, Maciver SK, Valladares B, Martínez-Carretero E. Therapeutic potential of a combination of two gene-specific small interfering RNAs against clinical strains of Acanthamoeba. Antimicrob Agents Chemother 2010; 54:5151-5. [PMID: 20855732 PMCID: PMC2981231 DOI: 10.1128/aac.00329-10] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2010] [Revised: 05/13/2010] [Accepted: 09/10/2010] [Indexed: 11/20/2022] Open
Abstract
Pathogenic strains of the genus Acanthamoeba are causative agents of severe infections, such as fatal encephalitis and a sight-threatening amoebic keratitis. Antimicrobial therapy for these infections is generally empirical, and patient recovery is often problematic, due to the existence of a highly resistant cyst stage in these amoebae. In previous studies, small interfering RNAs (siRNAs) against the catalytic domains of extracellular serine proteases and glycogen phosphorylase from Acanthamoeba were designed and evaluated for future therapeutic use. The silencing of proteases resulted in Acanthamoeba failing to degrade human corneal cells, and silencing of glycogen phosphorylase caused amoebae to be unable to form mature cysts. After the siRNA design and concentration were optimized in order to avoid toxicity problems, cultures of Acanthamoeba were treated with a combination of both siRNAs, and cells were evaluated under an inverted microscope. This siRNA-based treatment dramatically affected the growth rate and cellular survival of the amoebae. These results were observed less than 48 h after the initiation of the treatment. In order to check possible toxic effects of the siRNA combination, three eukaryotic cell lines (HeLa, murine macrophages, and osteosarcoma cells) were treated with the same molecules, and cytotoxicity was examined by measuring lactate dehydrogenase release. The future use of the combination of these siRNAs is proposed as a potential therapeutic approach against pathogenic strains of Acanthamoeba.
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Affiliation(s)
- Jacob Lorenzo-Morales
- University Institute of Tropical Diseases and Public Health of the Canary Islands, University of La Laguna, Avda. Astrofísico Fco. Sánchez, S/N 38203 La Laguna, Tenerife, Canary Islands, Spain.
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Diaz JH. Increasing Intracerebral Infections Caused by Free-Living Amebae in the United States and Worldwide. ACTA ACUST UNITED AC 2010. [DOI: 10.4303/jnp/n100801] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- James H. Diaz
- School of Public Health, Louisiana State University, Health Sciences Center New Orleans, 1615 Poydras St., Suite 1400, New Orleans, LA 70112, USA
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Saxena A, Mittal S, Burman P, Garg P. Acanthameba meningitis with successful outcome. Indian J Pediatr 2009; 76:1063-4. [PMID: 19907944 DOI: 10.1007/s12098-009-0205-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2008] [Accepted: 08/26/2008] [Indexed: 11/24/2022]
Abstract
We report a rare cause of sub acute meningitis in a 15-yr-old immunocompetent female child with successful outcome. The etiological agent was Acanthamoeba. The child was successfully treat with combination of Ketoconazole. Rifampicin, cotrimoxa zole and for a period of 9 month.
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Affiliation(s)
- Ajit Saxena
- Department of Pediatrics and Microbiology, Fortis Hospital, Sita Ram Bhartia Institute of Science and Research, New Delhi, India
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43
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Goze I, Alim A, Dag S, Tepe B, Polat ZA. In VitroAmoebicidal Activity ofSalvia stamineaandSalvia caespitosaonAcanthamoeba castellaniiand Their Cytotoxic Potentials on Corneal Cells. J Ocul Pharmacol Ther 2009; 25:293-8. [DOI: 10.1089/jop.2008.0132] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Ismihan Goze
- Vocational School of Health Services, Cumhuriyet University, Sivas, Turkey
| | - Ahmet Alim
- Public Health Laboratory, Sivas Health Directorate, Sivas, Turkey
| | - Seker Dag
- Department of Biology, Faculty of Science and Literature, Cumhuriyet University, Sivas, Turkey
| | - Bektas Tepe
- Department of Molecular Biology and Genetics, Faculty of Science and Literature, Cumhuriyet University, Sivas, Turkey
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Ranjan R, Handa A, Choudhary A, Kumar S. Acanthamoeba infection in an interhemispheric ependymal cyst: a case report. ACTA ACUST UNITED AC 2009; 72:185-9. [DOI: 10.1016/j.surneu.2008.04.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2007] [Accepted: 04/02/2008] [Indexed: 11/29/2022]
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Ku JY, Chan FM, Beckingsale P. Acanthamoebakeratitis cluster: an increase inAcanthamoebakeratitis in Australia. Clin Exp Ophthalmol 2009; 37:181-90. [DOI: 10.1111/j.1442-9071.2008.01910.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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46
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Gupta D, Panda GS, Bakhshi S. Successful treatment of acanthamoeba meningoencephalitis during induction therapy of childhood acute lymphoblastic leukemia. Pediatr Blood Cancer 2008; 50:1292-3. [PMID: 18253958 DOI: 10.1002/pbc.21477] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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47
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Fung KTT, Dhillon AP, McLaughlin JE, Lucas SB, Davidson B, Rolles K, Patch D, Burroughs AK. Cure of Acanthamoeba cerebral abscess in a liver transplant patient. Liver Transpl 2008; 14:308-12. [PMID: 18306348 DOI: 10.1002/lt.21409] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
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.
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Affiliation(s)
- Konrad Tang-Tat Fung
- Liver Transplantation and Hepatobiliary Medicine, Royal Free Hospital, London, United Kingdom
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Granulomatous amoebic encephalitis caused by Acanthamoeba amoebae of genotype T2 in a human immunodeficiency virus-negative patient. J Clin Microbiol 2007; 46:338-40. [PMID: 18003807 DOI: 10.1128/jcm.01177-07] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Acanthamoeba amoebae of genotype T2 were identified as the causative agent of Acanthamoeba skin lesions and granulomatous amoebic encephalitis (GAE) in a human immunodeficiency virus-negative patient with underlying tuberculosis. To our knowledge this, is the first case of GAE involving genotype T2.
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Yagi S, Schuster FL, Bloch K. Demonstration of presence of acanthamoeba mitochondrial DNA in brain tissue and cerebrospinal fluid by PCR in samples from a patient who died of granulomatous amebic encephalitis. J Clin Microbiol 2007; 45:2090-1. [PMID: 17409212 PMCID: PMC1933076 DOI: 10.1128/jcm.02435-06] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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50
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Readinger A, Blumberg M, Colome-Grimmer MI, Kelly E. Disseminated Acanthamoeba infection with sporotrichoid nodules. Int J Dermatol 2007; 45:942-3. [PMID: 16911379 DOI: 10.1111/j.1365-4632.2006.02850.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Allison Readinger
- University of Texas Medical Branch, Department of Dermatology, Galveston, TX 77555-0783, USA.
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