Abstract：
Acanthamoeba brain abscess is very rare and most often fatal. There remains no standardized regimen for its management. We report a case in northern Australia of an immunosuppressed 57-year-old man who presented with diarrhea and weight loss, and was diagnosed with multiple Acanthamoeba brain abscesses after neurological deterioration. This case is the first successful treatment with surgical excision followed by combination antimicrobial therapy including miltefosine. This case was treated initially as nocardiosis or melioidosis, emphasizing the importance of considering differentials such as Acanthamoeba during workup of atypical infection. We present a literature review of the 14 Acanthamoeba brain abscess cases reported in the English literature, of which five were successfully treated. Our review shows a predilection for multiple brain abscesses and an increased mortality rate compared with the general brain abscess population.
摘要：
棘阿米巴脑脓肿非常罕见，最常致命。目前尚无标准化的管理方案。我们在澳大利亚北部报道了一例免疫抑制的57岁男子腹泻和体重减轻，神经系统恶化后被诊断为多发性棘阿米巴脑脓肿。该病例是第一个成功的治疗方法，包括手术切除，然后进行包括米替福辛在内的联合抗菌治疗。该病例最初被治疗为诺卡心症或类鼻窦炎，强调在非典型感染检查期间考虑棘阿米巴等差异的重要性。我们对英语文献中报道的14例棘阿米巴脑脓肿病例进行了文献综述，其中5人成功治疗。我们的评论显示，与一般脑脓肿人群相比，多发性脑脓肿的倾向和死亡率增加。
