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Abstract：
BACKGROUND: The 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.
METHODS: We 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.
CONCLUSIONS: The 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.
METHODS: We 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.
CONCLUSIONS: The 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.
摘要：
背景：寄生虫溶组织内阿米巴是阿米巴病的病因，一种世界性的新兴疾病。阿米巴脑脓肿是一种罕见且经常致命的侵袭性阿米巴病。这种情况总是始于溶解组织的滋养体感染结肠，随后通过血流到达肠外组织。
方法：我们报告一例71岁女性意识状态改变，迷失方向，困倦和记忆丧失。她没有肝或肠阿米巴病的病史。根据核磁共振成像（NMRI）对胶体囊泡期神经囊虫病进行了初步诊断。手术后免疫荧光研究显示，溶组织大肠杆菌的140kDa纤连蛋白受体呈阳性，尽管通过ELISA进行的血清分析对针对该寄生虫的IgG抗体呈阴性。通过PCR在活检组织中鉴定了特定的溶组织大肠杆菌128bprRNA基因。最终诊断为脑阿米巴病。患者接受了神经外科手术以消除阿米巴脓肿，然后给予甲硝唑方案，头孢曲松和地塞米松在神经外科手术后4周。然而,她的病情迅速下降导致死亡。
结论：本例患者患有罕见形式的脑阿米巴病，突出了进行免疫荧光的重要性，NMRI和PCR，如果患者有脑脓肿和明确的诊断。此外，对这些患者施用皮质类固醇通常会导致他们的病情迅速下降。
方法：我们报告一例71岁女性意识状态改变，迷失方向，困倦和记忆丧失。她没有肝或肠阿米巴病的病史。根据核磁共振成像（NMRI）对胶体囊泡期神经囊虫病进行了初步诊断。手术后免疫荧光研究显示，溶组织大肠杆菌的140kDa纤连蛋白受体呈阳性，尽管通过ELISA进行的血清分析对针对该寄生虫的IgG抗体呈阴性。通过PCR在活检组织中鉴定了特定的溶组织大肠杆菌128bprRNA基因。最终诊断为脑阿米巴病。患者接受了神经外科手术以消除阿米巴脓肿，然后给予甲硝唑方案，头孢曲松和地塞米松在神经外科手术后4周。然而,她的病情迅速下降导致死亡。
结论：本例患者患有罕见形式的脑阿米巴病，突出了进行免疫荧光的重要性，NMRI和PCR，如果患者有脑脓肿和明确的诊断。此外，对这些患者施用皮质类固醇通常会导致他们的病情迅速下降。
