1
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Chao YP, Chen YH, Chien KH. Disseminated amoebic infection with orbital compartment syndrome. QJM 2023; 116:938-939. [PMID: 37449897 DOI: 10.1093/qjmed/hcad172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Indexed: 07/18/2023] Open
Affiliation(s)
- Yuan-Ping Chao
- Department of Ophthalmology, Kaohsiung Armed Forces General Hospital, Kaohsiung, 802, Taiwan (R.O.C.)
- Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei, 114, Taiwan (R.O.C.)
| | - Yi-Hao Chen
- Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei, 114, Taiwan (R.O.C.)
| | - Ke-Hung Chien
- Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei, 114, Taiwan (R.O.C.)
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2
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Wojtkowiak-Giera A, Derda M, Łanocha-Arendarczyk N, Kolasa A, Kot K, Walczykiewicz J, Solarczyk P, Kosik-Bogacka D. The Immunological Changes in the Skin of BALC/c Mice with Disseminated Acanthamoebiasis. Pathogens 2023; 12:pathogens12050631. [PMID: 37242301 DOI: 10.3390/pathogens12050631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 04/19/2023] [Accepted: 04/20/2023] [Indexed: 05/28/2023] Open
Abstract
Toll-like receptors (TLR) are involved in the recognition of numerous pathogens, including Acanthamoeba spp. Thanks to this, it is possible for immune cells to recognize microorganisms and trigger the body's innate immune response. The stimulation of TLRs also leads to the activation of specific immunity. The aim of the study was to determine the TLR2 and TLR4 gene expression in the skin of BALC/c mice infected with Acanthamoeba with AM22 strain isolated from a patient. Receptor expression was assessed by real-time polymerase chain reaction (qPCR) in the amoeba-infected host with normal (A) and reduced immunity (AS) as well as in the control host with normal immunity (C) and reduced immunity (CS). Statistical analysis of TLR2 gene expression in A and AS groups compared to C and CS groups, respectively, were statistically insignificant. In the A group, we found statistical upregulation of TLR4 gene expression at 8 dpi compared to the C group. While in AS group, TLR4 gene expression was at a similar level, such as in the CS group. Taking into account the host's immune status, the TLR4 gene expression was statistically higher in the skin of host from A group than in host from AS group at the beginning of the infection. Increased TLR4 gene expression in hosts with normal immunity infected with Acanthamoeba suggests the involvement of the studied receptor in the course of acanthamoebiasis. The above research results provide new data on the involvement of the studied receptor in the skin in the host's immune defense triggered during the Acanthamoeba infection.
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Affiliation(s)
- Agnieszka Wojtkowiak-Giera
- Department of Biology and Medical Parasitology, Poznan University of Medical Sciences, 60-781 Poznan, Poland
| | - Monika Derda
- Department of Biology and Medical Parasitology, Poznan University of Medical Sciences, 60-781 Poznan, Poland
| | - Natalia Łanocha-Arendarczyk
- Department of Biology and Medical Parasitology, Pomeranian Medical University in Szczecin, 70-111 Szczecin, Poland
| | - Agnieszka Kolasa
- Department of Histology and Embryology, Pomeranian Medical University in Szczecin, 70-111 Szczecin, Poland
| | - Karolina Kot
- Department of Biology and Medical Parasitology, Pomeranian Medical University in Szczecin, 70-111 Szczecin, Poland
| | - Joanna Walczykiewicz
- Department of Biology and Medical Parasitology, Poznan University of Medical Sciences, 60-781 Poznan, Poland
| | - Piotr Solarczyk
- Department of Biology and Medical Parasitology, Poznan University of Medical Sciences, 60-781 Poznan, Poland
| | - Danuta Kosik-Bogacka
- Independent of Pharmaceutical Botany, Pomeranian Medical University in Szczecin, 70-111 Szczecin, Poland
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3
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Haston JC, O’Laughlin K, Matteson K, Roy S, Qvarnstrom Y, Ali IKM, Cope JR. The Epidemiology and Clinical Features of Non-Keratitis Acanthamoeba Infections in the United States, 1956-2020. Open Forum Infect Dis 2023; 10:ofac682. [PMID: 36655187 PMCID: PMC9835757 DOI: 10.1093/ofid/ofac682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Indexed: 01/15/2023] Open
Abstract
Background Acanthamoeba is a free-living ameba that can cause severe disease affecting the central nervous system, skin, sinuses, and other organs, particularly in immunocompromised individuals. These rare but severe infections are often fatal, yet incompletely described. Methods Cases included were either reported to the Centers for Disease Control and Prevention (CDC) Free-Living Ameba program or published in scientific literature. Characteristics of all patients in the United States with laboratory-confirmed non-keratitis Acanthamoeba infections were described using descriptive statistics, and associations with survival were determined using χ2 and Fisher exact tests. Results Of 173 patients identified, 71% were male and the median age was 44 years (range, 0-87 years). Of these, 26 (15%) survived. Most patients (88%) had at least 1 immunocompromising condition, most commonly human immunodeficiency virus (39%), cancer (28%), and solid organ or hematopoietic stem cell transplant (28%). Granulomatous amebic encephalitis (GAE) was the most common disease presentation (71%). Skin (46%), sinuses (29%), lungs (13%), and bone (6%) were also involved. Nearly half of patients (47%) had involvement of >1 organ system. Survival was less frequent among those with GAE (3%, P < .001) compared with cutaneous disease, rhinosinusitis, or multiorgan disease not including GAE. Of 7 who received the currently recommended treatment regimen, 5 (71%) survived. Conclusions Non-keratitis Acanthamoeba infections occur primarily in immunocompromised individuals and are usually fatal. Survival may be associated with disease presentation and treatment. Providers who care for at-risk patients should be aware of the various disease manifestations to improve early recognition and treatment.
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Affiliation(s)
- Julia C Haston
- Correspondence: Julia C. Haston, MD, MSc, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA 30329, USA ()
| | - Kevin O’Laughlin
- Waterborne Disease Prevention Branch, Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Kelsey Matteson
- Waterborne Disease Prevention Branch, Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA,Epidemiology Elective Program, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Shantanu Roy
- Waterborne Disease Prevention Branch, Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Yvonne Qvarnstrom
- Parasitic Diseases Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Ibne K M Ali
- Waterborne Disease Prevention Branch, Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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4
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Stetkevich SA, Le ST, Ford AR, Brassard A, Kiuru M, Fung MA, Tartar DM. Isolated cutaneous acanthamoebiasis under prophylactic anticryptococcal treatment in an immunocompromised patient. JAAD Case Rep 2022; 28:77-79. [PMID: 36097622 PMCID: PMC9463523 DOI: 10.1016/j.jdcr.2022.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
- Samuel A. Stetkevich
- Division of Dermatology, Department of Medicine, University of Toledo College of Medicine, Toledo, Ohio
| | - Stephanie T. Le
- Department of Dermatology, University of California, Davis, Davis, California
| | - Adam R. Ford
- Department of Dermatology, University of California, Davis, Davis, California
| | - Alain Brassard
- Department of Dermatology, University of California, Davis, Davis, California
| | - Maija Kiuru
- Department of Dermatology, University of California, Davis, Davis, California
- Department of Dermatopathology, University of California, Davis, Davis, California
| | - Maxwell A. Fung
- Department of Dermatology, University of California, Davis, Davis, California
- Department of Dermatopathology, University of California, Davis, Davis, California
| | - Danielle M. Tartar
- Department of Dermatology, University of California, Davis, Davis, California
- Correspondence to: Danielle M. Tartar, MD, PhD, University of California, Davis, 3301 C Street, Suite 1400, Sacramento, CA 95819.
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5
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Seas C, Legua P. Meningoencephalitis Due to Free-Living Amoebas in the Tropics. CURRENT TROPICAL MEDICINE REPORTS 2022. [DOI: 10.1007/s40475-022-00254-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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6
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Oranges T, Veraldi S, Granieri G, Fidanzi C, Janowska A, Dini V, Romanelli M. Parasites causing cutaneous wounds: Theory and practice from a dermatological point of view. Acta Trop 2022; 228:106332. [PMID: 35092728 DOI: 10.1016/j.actatropica.2022.106332] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 01/20/2022] [Accepted: 01/25/2022] [Indexed: 11/27/2022]
Abstract
A wide range of parasites can infest open wounds, or cause wounds due to the effects of the infestation. Parasitic infestations can involve the skin and subcutaneous tissues, with various clinical manifestations. In case of cutaneous wounds related to infestations, protozoa, helminths and arthropods are the main groups of parasites involved and emerging new aspects have been recently reported. Treating the wound correctly is fundamental in these patients in order to reduce the development of pathological scars and prevent complications. In particular, a gentle debridement for devitalized/infested tissue removal, the appropriate use of topical antiseptics and dressings such as hydrogel, hydrocolloids and antimicrobial dressings can be useful to control superinfections, moisture balance, inflammation and to promote edge proliferation.
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Affiliation(s)
- Teresa Oranges
- Department of Dermatology, University of Pisa, Via Roma 67, Pisa 56126, Italy; Department of Pediatrics, Dermatology Unit, Meyer Children's University Hospital, Florence, Italy
| | - Stefano Veraldi
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Giammarco Granieri
- Department of Dermatology, University of Pisa, Via Roma 67, Pisa 56126, Italy
| | - Cristian Fidanzi
- Department of Dermatology, University of Pisa, Via Roma 67, Pisa 56126, Italy
| | - Agata Janowska
- Department of Dermatology, University of Pisa, Via Roma 67, Pisa 56126, Italy
| | - Valentina Dini
- Department of Dermatology, University of Pisa, Via Roma 67, Pisa 56126, Italy
| | - Marco Romanelli
- Department of Dermatology, University of Pisa, Via Roma 67, Pisa 56126, Italy.
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7
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Clinical Improvement of Disseminated Acanthamoeba Infection in a Patient with Advanced HIV Using a Non-Miltefosine-Based Treatment Regimen in a Low-Resource Setting. Trop Med Infect Dis 2022; 7:tropicalmed7020024. [PMID: 35202219 PMCID: PMC8874976 DOI: 10.3390/tropicalmed7020024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 02/01/2022] [Accepted: 02/02/2022] [Indexed: 11/26/2022] Open
Abstract
Disseminated Acanthamoeba species infection is likely an underrecognized and underdiagnosed opportunistic infection in patients with advanced human immunodeficiency virus (HIV) disease in South Africa. It presents a unique clinical challenge in that the diagnosis can be difficult to establish and management options are limited in low-resource settings. To our knowledge, there is a paucity of literature to date on the successful use of combination treatment options for patients in low-resource settings without access to miltefosine. We present a case describing the clinical improvement of disseminated Acanthamoeba infection in a patient with advanced HIV using a non-miltefosine-based treatment regimen. The case serves to highlight that Acanthamoeba sp. infection should be considered as a differential diagnosis for nodular and ulcerative cutaneous lesions in patients with advanced HIV in South Africa, and that although there are alternative options for combination treatment in countries without access to miltefosine, efforts should be made to advocate for better access to miltefosine for the treatment of acanthamoebiasis in South Africa.
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8
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Teh JSK, Tam PCK, Badenoch PR, Adamson PJ, Brennan C, Marshman G, Gordon DL. Successful treatment of cutaneous Acanthamoeba castellanii infection with miltefosine in a patient with chronic lymphocytic leukaemia on ibrutinib. J Antimicrob Chemother 2021; 77:539-541. [PMID: 34747467 DOI: 10.1093/jac/dkab397] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Accepted: 10/06/2021] [Indexed: 11/14/2022] Open
Affiliation(s)
- Joanne S K Teh
- Department of Microbiology and Infectious Diseases, Flinders Medical Centre, Flinders Drive, Bedford Park, South Australia 5042, Australia.,SA Pathology, Flinders Medical Centre, Flinders Drive, Bedford Park, South Australia 5042, Australia
| | - Patrick C K Tam
- Department of Microbiology and Infectious Diseases, Flinders Medical Centre, Flinders Drive, Bedford Park, South Australia 5042, Australia.,College of Medicine and Public Health, Flinders University, Sturt Road, Bedford Park, South Australia 5042, Australia
| | - Paul R Badenoch
- College of Medicine and Public Health, Flinders University, Sturt Road, Bedford Park, South Australia 5042, Australia.,Department of Ophthalmology, Flinders Medical Centre, Flinders Drive, Bedford Park, South Australia 5042, Australia
| | - Penelope J Adamson
- Department of Microbiology and Infectious Diseases, Flinders Medical Centre, Flinders Drive, Bedford Park, South Australia 5042, Australia.,SA Pathology, Flinders Medical Centre, Flinders Drive, Bedford Park, South Australia 5042, Australia.,College of Medicine and Public Health, Flinders University, Sturt Road, Bedford Park, South Australia 5042, Australia
| | - Catriona Brennan
- SA Pathology, Flinders Medical Centre, Flinders Drive, Bedford Park, South Australia 5042, Australia.,Department of Anatomical Pathology, Flinders Medical Centre, Flinders Drive, Bedford Park, South Australia 5042, Australia
| | - Gillian Marshman
- Department of Dermatology, Flinders Medical Centre, Flinders Drive, Bedford Park, South Australia 5042, Australia
| | - David L Gordon
- Department of Microbiology and Infectious Diseases, Flinders Medical Centre, Flinders Drive, Bedford Park, South Australia 5042, Australia.,SA Pathology, Flinders Medical Centre, Flinders Drive, Bedford Park, South Australia 5042, Australia.,College of Medicine and Public Health, Flinders University, Sturt Road, Bedford Park, South Australia 5042, Australia
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9
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Abstract
Infections caused by Naegleria fowleri, Acanthamoeba spp., and Balamuthia mandrillaris result in a variety of clinical manifestations in humans. These amoebae are found in water and soil worldwide. Acanthamoeba spp. and B. mandrillaris cause granulomatous amoebic encephalitis, which usually presents as a mass, while N. fowleri causes primary amoebic meningoencephalitis. Acanthamoeba spp. can also cause keratitis, and both Acanthamoeba spp. and B. mandrillaris can cause lesions in skin and respiratory mucosa. These amoebae can be difficult to diagnose clinically as these infections are rare and, if not suspected, can be misdiagnosed with other more common diseases. Microscopy continues to be the key first step in diagnosis but the amoeba can be confused with macrophages or other infectious agents if an expert in infectious disease pathology or clinical microbiology is not consulted. Although molecular methods can be helpful in establishing the diagnosis, these are only available in referral centers. Treatment requires combination of antibiotics and antifungals and, even with prompt diagnosis and treatment, mortality for neurological disease is extremely high.
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10
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Morphological Description of the Early Events during the Invasion of Acanthamoeba castellanii Trophozoites in a Murine Model of Skin Irradiated under UV-B Light. Pathogens 2020; 9:pathogens9100794. [PMID: 32992452 PMCID: PMC7600863 DOI: 10.3390/pathogens9100794] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 08/27/2020] [Accepted: 09/24/2020] [Indexed: 11/17/2022] Open
Abstract
Skin infections have been associated with Acanthamoeba, nevertheless the events during skin invasion and UV-B light effects on it are unknown. The early morphological events of Acanthamoeba castellanii skin invasion are shown in SKH-1 mice that were chronically UV-B light irradiated. Mice that developed skin lesions (group 1) were topical and intradermally inoculated with A. castellanii trophozoites and sacrificed 48 h or 18 days later. Mice that showed no skin lesions (group 2) were intradermally inoculated and sacrificed 24, 48 or 72 h later. Mice ventral areas were considered controls with and without trophozoites intradermally inoculated. Skin samples were processed by histological and immunohistochemistry techniques. In group 1, trophozoites were immunolocalized in dermal areas, hair cysts, sebaceous glands, and blood vessels, and collagen degradation was observed. One of these mice shown trophozoites in the spleen, liver, and brain. In group 2, few trophozoites nearby collagenolytic activity zones were observed. In control samples, nor histological damage and no trophozoites were observed. Adherence and collagenolytic activity by A. castellanii were corroborated in vitro. We can infer that UV-B light irradiated skin could favor A. castellanii invasiveness causing damage in sites as far away as the brain, confirming the invasive capacity and pathogenic potential of these amphizoic amoebae.
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11
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Kutner A, Aldrich M, Patel S, Kang JJ, Amin B, Mann R, Ali IKM, Martines RB, Cope JR, De Boccardo GO, Puius YA. Acanthamoeba endophthalmitis during treatment for cutaneous disease in a renal transplant patient. Transpl Infect Dis 2018; 20:e12843. [PMID: 29359845 DOI: 10.1111/tid.12843] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Revised: 08/18/2017] [Accepted: 09/08/2017] [Indexed: 11/28/2022]
Abstract
Acanthamoeba infections are difficult to diagnose and treat. We present a renal transplant patient who developed Acanthamoeba endophthalmitis on therapy with posaconazole and miltefosine for cutaneous acanthamobiasis. The patient was maintained on intracameral voriconazole injections, and oral azithromycin, fluconazole, and flucytosine. This case highlights novel presentations and treatments for acanthamoebic infection.
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Affiliation(s)
- Allison Kutner
- Department of Dermatology, Montefiore Medical Center, Bronx, NY, USA
| | - Margaret Aldrich
- Division of Infectious Diseases, Department of Medicine, Montefiore Medical Center, Bronx, NY, USA
| | - Sarju Patel
- Department of Ophthalmology, Weill Cornell Medical Center, New York, NY, USA
| | - Joann J Kang
- Department of Ophthalmology, Montefiore Medical Center, Bronx, NY, USA
| | - Bijal Amin
- Department of Pathology, Montefiore Medical Center, Bronx, NY, USA
| | - Ranon Mann
- Department of Dermatology, Montefiore Medical Center, Bronx, NY, USA
| | - Ibne Karim M Ali
- Waterborne Disease Prevention Branch, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Jennifer Rittenhouse Cope
- Waterborne Disease Prevention Branch, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Yoram A Puius
- Division of Infectious Diseases, Department of Medicine, Montefiore Medical Center, Bronx, NY, USA
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12
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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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13
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Sullivan KE, Bassiri H, Bousfiha AA, Costa-Carvalho BT, Freeman AF, Hagin D, Lau YL, Lionakis MS, Moreira I, Pinto JA, de Moraes-Pinto MI, Rawat A, Reda SM, Reyes SOL, Seppänen M, Tang MLK. Emerging Infections and Pertinent Infections Related to Travel for Patients with Primary Immunodeficiencies. J Clin Immunol 2017; 37:650-692. [PMID: 28786026 PMCID: PMC5693703 DOI: 10.1007/s10875-017-0426-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Accepted: 07/21/2017] [Indexed: 12/18/2022]
Abstract
In today's global economy and affordable vacation travel, it is increasingly important that visitors to another country and their physician be familiar with emerging infections, infections unique to a specific geographic region, and risks related to the process of travel. This is never more important than for patients with primary immunodeficiency disorders (PIDD). A recent review addressing common causes of fever in travelers provides important information for the general population Thwaites and Day (N Engl J Med 376:548-560, 2017). This review covers critical infectious and management concerns specifically related to travel for patients with PIDD. This review will discuss the context of the changing landscape of infections, highlight specific infections of concern, and profile distinct infection phenotypes in patients who are immune compromised. The organization of this review will address the environment driving emerging infections and several concerns unique to patients with PIDD. The first section addresses general considerations, the second section profiles specific infections organized according to mechanism of transmission, and the third section focuses on unique phenotypes and unique susceptibilities in patients with PIDDs. This review does not address most parasitic diseases. Reference tables provide easily accessible information on a broader range of infections than is described in the text.
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Affiliation(s)
- Kathleen E Sullivan
- Division of Allergy and Immunology, The Children's Hospital of Philadelphia, 3615 Civic Center Blvd., Philadelphia, PA, 19104, USA.
| | - Hamid Bassiri
- Division of Infectious Diseases and Center for Childhood Cancer Research, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, 3501 Civic Center Boulevard, Philadelphia, PA, 19104, USA
| | - Ahmed A Bousfiha
- Clinical Immunology Unit, Infectious Department, Hopital d'Enfant Abderrahim Harouchi, CHU Ibn Rochd, Laboratoire d'Immunologie Clinique, d'Inflammation et d'Allergie LICIA, Faculté de Médecine et de Pharmacie, Université Hassan II, Casablanca, Morocco
| | - Beatriz T Costa-Carvalho
- Department of Pediatrics, Federal University of São Paulo, Rua dos Otonis, 725, São Paulo, SP, 04025-002, Brazil
| | - Alexandra F Freeman
- NIAID, NIH, Building 10 Room 12C103, 9000 Rockville, Pike, Bethesda, MD, 20892, USA
| | - David Hagin
- Division of Allergy and Immunology, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, University of Tel Aviv, 6 Weizmann St, 64239, Tel Aviv, Israel
| | - Yu L Lau
- Department of Paediatrics & Adolescent Medicine, The University of Hong Kong, Rm 106, 1/F New Clinical Building, Pok Fu Lam, Hong Kong.,Queen Mary Hospital, 102 Pokfulam Road, Pok Fu Lam, Hong Kong
| | - Michail S Lionakis
- Fungal Pathogenesis Unit, Laboratory of Clinical Infectious Diseases, National Institute of Allergy & Infectious Diseases (NIAID), National Institutes of Health (NIH), 9000 Rockville Pike, Building 10, Room 11C102, Bethesda, MD, 20892, USA
| | - Ileana Moreira
- Immunology Unit, Hospital de Niños Ricardo Gutiérrez, Gallo 1330, 1425, Buenos Aires, Argentina
| | - Jorge A Pinto
- Division of Immunology, Department of Pediatrics, Federal University of Minas Gerais, Av. Alfredo Balena 190, room # 161, Belo Horizonte, MG, 30130-100, Brazil
| | - M Isabel de Moraes-Pinto
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Federal University of São Paulo, Rua Pedro de Toledo, 781/9°andar, São Paulo, SP, 04039-032, Brazil
| | - Amit Rawat
- Pediatric Allergy and Immunology, Department of Pediatrics, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Shereen M Reda
- Pediatric Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Saul Oswaldo Lugo Reyes
- Immunodeficiencies Research Unit, National Institute of Pediatrics, Av Iman 1, Torre de Investigacion, Piso 9, Coyoacan, 04530, Mexico City, Mexico
| | - Mikko Seppänen
- Harvinaissairauksien yksikkö (HAKE), Rare Disease Center, Helsinki University Hospital (HUH), Helsinki, Finland
| | - Mimi L K Tang
- Murdoch Children's Research Institute, The Royal Children's Hospital, University of Melbourne, Melbourne, Australia
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14
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Xuan Y, Shen Y, Ge Y, Yan G, Zheng S. Isolation and identification of Acanthamoeba strains from soil and tap water in Yanji, China. Environ Health Prev Med 2017; 22:58. [PMID: 29165144 PMCID: PMC5664816 DOI: 10.1186/s12199-017-0655-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Accepted: 04/28/2017] [Indexed: 11/20/2022] Open
Abstract
Background Members of the genus Acanthamoeba are widely distributed throughout the world, and some of them are considered pathogenic, as they are capable of causing corneal and central nervous system diseases. In this study, we isolated Acanthamoeba strains from soil and tap water in Yanji, China. Methods We identified four strains of Acanthamoeba (CJY/S1, CJY/S2, CJY/S3, and CJY/W1) using mitochondrial DNA restriction fragment length polymorphism (mtDNA RFLP) analysis. Nuclear 18S rDNA sequences were used for phylogenetic analysis and species identification. Results Genotypic characterization of the isolates showed that they belonged to genotypes T4 (CJY/S1 and CJY/S2), T5 (CJY/S3), and T16 (CJY/W1). Sequence differences between CJY/S1 and Acanthamoeba castellanii Neff, CJY/S2 and Acanthamoeba KA/E7, and CJY/S3 and Acanthamoeba lenticulata 68–2 were 0.31, 0.2, and 0.26%, respectively. 18S ribosomal deoxyribonucleic acid (rDNA) of CJY/W1 had 99% sequence identity to that of Acanthamoeba sp. U/H-C1. Strains CJY/S1 and CJY/S2, isolated from soil, had similar mtDNA RFLP patterns, whereas strain CJY/W1, isolated from tap water, displayed a different pattern. Conclusions To the best of our knowledge, this is the first report on the identification of genotypes T4, T5, and T16 from environmental sources in Yanji, China.
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Affiliation(s)
- Yinghua Xuan
- Department of Basic Medicine, Medical School, Jiangnan University, 1800 Li Hu Road, Wuxi, 214122, Jiangsu, China
| | - Yanqin Shen
- Department of Basic Medicine, Medical School, Jiangnan University, 1800 Li Hu Road, Wuxi, 214122, Jiangsu, China
| | - Yuxi Ge
- Department of Radiology, Affiliated Hospital of Jiangnan University, No. 200 Huihe Road, Wuxi, 214062, Jiangsu, China
| | - Gen Yan
- Department of Radiology, Affiliated Hospital of Jiangnan University, No. 200 Huihe Road, Wuxi, 214062, Jiangsu, China
| | - Shanzi Zheng
- Department of Parasitology, College of Medicine, Yanbian University, Yanji, 133000, Jilin, China.
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15
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Balamuthia mandrillaris en el Perú, lesiones cutáneas, meningoencefalitis y métodos de cultivo. INFECTIO 2016. [DOI: 10.1016/j.infect.2015.10.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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16
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Morrison AO, Morris R, Shannon A, Lauer SR, Guarner J, Kraft CS. Disseminated Acanthamoeba Infection Presenting With Cutaneous Lesions in an Immunocompromised Patient: A Case Report, Review of Histomorphologic Findings, and Potential Diagnostic Pitfalls. Am J Clin Pathol 2016; 145:266-70. [PMID: 26800765 DOI: 10.1093/ajcp/aqv081] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES Free-living amoebas are exceedingly rare causes of cutaneous infections and present unique diagnostic and therapeutic challenges. We describe a case of disseminated acanthamoebiasis with cutaneous manifestations and summarize additional diagnostic, prognostic, and therapeutic highlights. METHODS A 58-year-old man with relapsed chronic lymphocytic leukemia had several weeks of progressive, painful ulcerations on the forehead, arms, abdomen, and thighs. A biopsy was performed for histopathologic evaluation. RESULTS The biopsy specimen showed inflammatory infiltrate with abscess formation involving the epidermis, dermis, and subcutis. Scattered cells showed nuclei with a prominent central karyosome, dispersed chromatin, and either abundant foamy basophilic cytoplasm or two well-demarcated cytoplasmic walls. Acanthamoeba species was confirmed by polymerase chain reaction from the formalin-fixed, paraffin-embedded tissue. CONCLUSIONS Cutaneous lesions from acanthamoebiasis are exceptionally rare but should be included in the differential diagnosis of necrotic cutaneous lesions in immunocompromised patients. Although infrequently encountered, pathologists need to be aware of the morphologic features of free-living amoebas. Immunohistochemical and molecular studies can confirm the diagnosis. Multiagent treatment regimens, when initiated empirically, have been more successful than single-agent regimens, but infections involving the central nervous system are almost universally fatal.
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Affiliation(s)
| | - Robert Morris
- From the Departments of Pathology and Laboratory Medicine Dermatology, Emory University, Atlanta, GA
| | - Amie Shannon
- Department of Dermatology, Louisiana State University, Baton Rouge
| | - Scott R Lauer
- Department of Pathology, Alegent Creighton Health, Omaha, NE
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17
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Derda M, Hadaś E, Cholewiński M, Skrzypczak Ł, Grzondziel A, Wojtkowiak-Giera A. Artemisia annua L. as a plant with potential use in the treatment of acanthamoebiasis. Parasitol Res 2016; 115:1635-9. [PMID: 26782959 PMCID: PMC4799240 DOI: 10.1007/s00436-016-4902-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Accepted: 01/06/2016] [Indexed: 12/01/2022]
Abstract
The treatment of acanthamoebiasis is a great problem. Most cerebral invasions end with death, and the treatment of ocular invasions is usually long-lasting and not very effective. Numerous plant extracts and substances isolated from plants, which are effective against trophozoites or cysts, have been studied in the treatment of acanthamoebiasis. However, no agents that are simultaneously effective against both developing forms of amoebae have been discovered yet. It seems that such a plant which fulfils both tasks is Artemisia annua L. Our studies showed that water, alcohol and chloroform extracts from the herb A. annua L. can be applied in general and local treatment or in combined therapy with antibiotics in the treatment of acanthamoebiasis. Extracts from this plant show not only in vitro but also in vivo effects. Studies carried out on experimental animals infected with amoebae show that the application of these extracts significantly prolongs the survival of the animals.
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Affiliation(s)
- Monika Derda
- Department of Biology and Medical Parasitology, Poznan University of Medical Sciences, 10 Fredry Street, 61-701, Poznan, Poland.
| | - Edward Hadaś
- Department of Biology and Medical Parasitology, Poznan University of Medical Sciences, 10 Fredry Street, 61-701, Poznan, Poland
| | - Marcin Cholewiński
- Department of Biology and Medical Parasitology, Poznan University of Medical Sciences, 10 Fredry Street, 61-701, Poznan, Poland
| | - Łukasz Skrzypczak
- Department of Biology and Medical Parasitology, Poznan University of Medical Sciences, 10 Fredry Street, 61-701, Poznan, Poland
| | - Anna Grzondziel
- Department of Biology and Medical Parasitology, Poznan University of Medical Sciences, 10 Fredry Street, 61-701, Poznan, Poland
| | - Agnieszka Wojtkowiak-Giera
- Department of Biology and Medical Parasitology, Poznan University of Medical Sciences, 10 Fredry Street, 61-701, Poznan, Poland
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Cabello-Vílchez AM, Martín-Navarro CM, López-Arencibia A, Reyes-Batlle M, Sifaoui I, Valladares B, Piñero JE, Lorenzo-Morales J. Voriconazole as a first-line treatment against potentially pathogenic Acanthamoeba strains from Peru. Parasitol Res 2013; 113:755-9. [DOI: 10.1007/s00436-013-3705-8] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2013] [Accepted: 11/13/2013] [Indexed: 11/25/2022]
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19
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Affiliation(s)
- Mark D. Hoffman
- Department of Dermatology; Rush University Medical Center; Chicago; Illinois
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20
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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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