PDF(Pubmed)
Abstract：
Acanthamoeba spp. are rare etiological agents of meningoencephalitis with high mortality. We present three cases of Acanthamoeba meningoencephalitis in immunocompetent individuals from Eastern India. The first patient presented with fever and headache; the second with headache, visual disturbance, and squint; and the third presented in a drowsy state. The cases presented on March 3, 18, and 21, 2023 respectively. The first two patients had concomitant tubercular meningitis for which they received antitubercular therapy and steroid. Their cerebrospinal fluid showed slight lymphocytic pleocytosis and increased protein. The diagnosis was done by microscopy, culture, and polymerase chain reaction. They received a combination therapy comprising rifampicin, fluconazole, and trimethoprim-sulfamethoxazole. The first patient additionally received miltefosine. She responded well to therapy and survived, but the other two patients died despite intensive care. Detection of three cases within a period of 1 month from Eastern India is unusual. It is imperative to sensitize healthcare providers about Acanthamoeba meningoencephalitis to facilitate timely diagnosis and treatment of the disease.
摘要：
棘阿米巴。是死亡率高的脑膜脑炎的罕见病因。我们介绍了来自印度东部免疫功能正常的个体中的三例棘阿米巴脑膜脑炎。第一位患者出现发烧和头痛；第二位患者出现头痛，视觉障碍,斜视；第三个处于昏昏欲睡的状态。病例分别于2023年3月3日、18日和21日提出。前两名患者并发结核性脑膜炎，他们接受了抗结核治疗和类固醇治疗。他们的脑脊液显示轻度淋巴细胞增多和蛋白质增加。通过显微镜诊断，文化,和聚合酶链反应。他们接受了包含利福平的联合治疗，氟康唑,和甲氧苄啶-磺胺甲恶唑.第一位患者还接受了米替福辛。她对治疗反应良好，活了下来，但另外两名患者尽管接受了重症监护，却死亡了。在印度东部1个月内发现三例病例是不寻常的。必须使医疗保健提供者对棘阿米巴脑膜脑炎敏感，以促进及时诊断和治疗该疾病。
