Abstract：
Granulomatous amoebic encephalitis due to Acanthamoeba spp is a rare, near-fatal central nervous system infection. It is often seen in immunocompromised individuals. Here we describe a survivor of this infection who was co-infected with multidrug-resistant tuberculosis. He presented to us with features of meningitis and a history of chronic cough. The chest X-ray was classical for pulmonary tuberculosis. Neuroimaging was suggestive of encephalitis; herpes simplex virus PCR was negative. Cerebrospinal fluid (CSF) showed lymphocytic pleocytosis. Wet mounts revealed trophozoites of Acanthamoeba Currently, he is being treated with oral bedaquiline, levofloxacin, linezolid, clofazimine, cycloserine and pyridoxine for tuberculosis. He received intravenous amikacin and oral cotrimoxazole and fluconazole for Acanthamoeba infection for 1 month. The resolution was confirmed by repeating the CSF wet mount, culture and neuroimaging. He was then discharged with oral rifampicin, cotrimoxazole and fluconazole. He is currently under our close follow-up.
摘要：
由于棘阿米巴属引起的肉芽肿性阿米巴脑炎是一种罕见的，近乎致命的中枢神经系统感染.它常见于免疫受损的个体。在这里，我们描述了这种感染的幸存者，他同时感染了耐多药结核病。他向我们介绍了脑膜炎的特征和慢性咳嗽的病史。胸部X线片是典型的肺结核。神经影像学提示脑炎；单纯疱疹病毒PCR阴性。脑脊液（CSF）显示淋巴细胞增多。湿坐骑揭示了棘阿米巴的滋养体目前，他正在口服bedaquiline治疗，左氧氟沙星,利奈唑胺,氯法齐明,环丝氨酸和吡哆醇治疗结核病。他接受了1个月的阿米卡星静脉注射和口服复方新诺明和氟康唑治疗棘阿米巴感染。通过重复CSF湿式安装来确认分辨率，文化和神经影像学。然后他口服利福平出院，复方新诺明和氟康唑.他目前正在接受我们的密切跟进。
