Case report: multiple and atypical amoebic cerebral abscesses resistant to treatment
| Autor: | Manuel Enrique Ávila-Blanco, Aurelio López-Morones, Javier Ventura-Juárez, Daniel Cervantes-García, Joaquin Alvaro Victoria-Hernández, Sandra Luz Martínez-Hernández, Marina Nayeli Medina-Rosales, Anayansi Ventura-Saucedo, Luis Fernando Barba-Gallardo, Martín Humberto Muñoz-Ortega |
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| Rok vydání: | 2020 |
| Předmět: |
0301 basic medicine
Pathology medicine.medical_specialty 030231 tropical medicine Neurocysticercosis Case Report NMRI Central Nervous System Parasitic Infections Immunofluorescence Dexamethasone Neurosurgical Procedures 140 kDa fibronectin receptor lcsh:Infectious and parasitic diseases 03 medical and health sciences Entamoeba histolytica Fatal Outcome 0302 clinical medicine Metronidazole Biopsy medicine Animals Humans Serologic Tests lcsh:RC109-216 Amoebiasis Brain abscess Aged Entamoebiasis medicine.diagnostic_test biology business.industry Ceftriaxone Cerebral amoebiasis DNA Protozoan medicine.disease biology.organism_classification Combined Modality Therapy PCR 030104 developmental biology Infectious Diseases Drug Therapy Combination Female business medicine.drug |
| Zdroj: | BMC Infectious Diseases BMC Infectious Diseases, Vol 20, Iss 1, Pp 1-6 (2020) |
| ISSN: | 1471-2334 |
| DOI: | 10.1186/s12879-020-05391-y |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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