1. Case report: multiple and atypical amoebic cerebral abscesses resistant to treatment.
- Author
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Victoria-Hernández JA, Ventura-Saucedo A, López-Morones A, Martínez-Hernández SL, Medina-Rosales MN, Muñoz-Ortega M, Ávila-Blanco ME, Cervantes-García D, Barba-Gallardo LF, and Ventura-Juárez J
- Subjects
- Aged, Animals, Brain Abscess drug therapy, Brain Abscess surgery, Ceftriaxone administration & dosage, Central Nervous System Parasitic Infections drug therapy, Central Nervous System Parasitic Infections pathology, Central Nervous System Parasitic Infections surgery, Combined Modality Therapy, DNA, Protozoan analysis, Dexamethasone administration & dosage, Drug Therapy, Combination, Entamoeba histolytica genetics, Entamoeba histolytica immunology, Entamoeba histolytica isolation & purification, Entamoebiasis drug therapy, Entamoebiasis pathology, Entamoebiasis surgery, Fatal Outcome, Female, Humans, Metronidazole administration & dosage, Neurosurgical Procedures, Serologic Tests, Brain Abscess diagnosis, Brain Abscess parasitology, Central Nervous System Parasitic Infections diagnosis, Entamoebiasis diagnosis
- 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., Case Presentation: 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.
- Published
- 2020
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