Case report: multiple and atypical amoebic cerebral abscesses resistant to treatment

BMC Infectious Diseases

Joaquin Alvaro Victoria-Hernández¹  Anayansi Ventura-Saucedo²  Daniel Cervantes-García³  Marina Nayeli Medina-Rosales⁴  Javier Ventura-Juárez⁴  Sandra Luz Martínez-Hernández⁴  Manuel Enrique Ávila-Blanco⁴  Aurelio López-Morones⁵  Luis Fernando Barba-Gallardo⁶  Martín Muñoz-Ortega⁷ 

[1] Departamento de Anatomía Patológica, Hospital General de Zona 3 IMSS Jesús María, Prolongación General Ignacio Zaragoza 905, Jesús María, CP 20908, Aguascalientes, AGS, Mexico;Departamento de Anestesiología, Hospital General de Zona 3 IMSS Jesús María, Prolongación General Ignacio Zaragoza 905, Jesús María, CP 20908, Aguascalientes, AGS, Mexico;Departamento de Microbiología, Centro de Ciencias Básicas, Universidad Autónoma de Aguascalientes, CP 20131, Aguascalientes, AGS, Mexico;Consejo Nacional de Ciencia y Tecnología, CONACYT, 03940, Ciudad de México, Mexico;Departamento de Morfología, Centro de Ciencias Básicas, Universidad Autónoma de Aguascalientes, Ed. 202 Av Universidad # 940, Ciudad Universitaria, CP 20131, Aguascalientes, AGS, Mexico;Departamento de Neurocirugía, Hospital General de Zona 3 IMSS Jesús María, Prolongación General Ignacio Zaragoza 905, Jesús María, CP 20908, Aguascalientes, AGS, Mexico;Departamento de Optometría, Centro de Ciencias de la Salud, Universidad Autónoma de Aguascalientes, CP 20131, Aguascalientes, AGS, Mexico;Departamento de Química, Centro de Ciencias Básicas, Universidad Autónoma de Aguascalientes, CP 20131, Aguascalientes, AGS, Mexico;

关键词: Cerebral amoebiasis;    Entamoeba histolytica;    NMRI;    PCR;    140 kDa fibronectin receptor;    Brain abscess;   

DOI  :  10.1186/s12879-020-05391-y

来源: Springer

【 摘 要 】

BackgroundThe parasite Entamoeba histolytica is the causal agent of amoebiasis, a worldwide emerging disease. Amebic brain abscess is a form of invasive amebiasis that is both rare and frequently lethal. This condition always begins with the infection of the colon by E. histolytica trophozoites, which subsequently travel through the bloodstream to extraintestinal tissues.Case presentationWe report a case of a 71-year-old female who reported an altered state of consciousness, disorientation, sleepiness and memory loss. She had no history of hepatic or intestinal amoebiasis. A preliminary diagnosis of colloidal vesicular phase neurocysticercosis was made based on nuclear magnetic resonance imaging (NMRI). A postsurgery immunofluorescence study was positive for the 140 kDa fibronectin receptor of E. histolytica, although a serum analysis by ELISA was negative for IgG antibodies against this parasite. A specific E. histolytica 128 bp rRNA gene was identified by PCR in biopsy tissue. The final diagnosis was cerebral amoebiasis. The patient underwent neurosurgery to eliminate amoebic abscesses and was then given a regimen of metronidazole, ceftriaxone and dexamethasone for 4 weeks after the neurosurgery. However, a rapid decline in her condition led to death.ConclusionsThe present case of an individual with a rare form of cerebral amoebiasis highlights the importance of performing immunofluorescence, NMRI and PCR if a patient has brain abscess and a poorly defined diagnosis. Moreover, the administration of corticosteroids to such patients can often lead to a rapid decline in their condition.

【 授权许可】

CC BY