Amoebic Cerebral Abscess: Still A Diagnostic Dilemma with Fatal Outcome
Keywords:
abscess, amoebiasis, cerebral, Entamoeba
Abstract
Amoebiasis is defined as infection with Entamoeba histolytica, which enters the body through feco – oral route after consumption of food or water contaminated by cysts. We present a rare case of amoebic brain abscess in a 45 years old patient who came with headache, fever and right sided weakness for 15 days. He was emperically being treated for tuberculosis. As Entamoeba was not suspected, no serological or microbiological investigations for the same were done. Histopathological examination of abscess sent after frontal lobectomy revealed trophozoites of Entamoeba histolytica. Demonstration of trophozoites of Entamoeba on histopathology sections was a surprising finding which clinched the diagnosis in this case. Amoebic brain abscess should be considered as differential diagnosis in all patients who present with signs & symptoms of central nervous system involvement in endemic areas. Early diagnosis and aggressive management with metronidazole is imperative to limit the morbidity and prevent the mortality.References
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2. Chatterjee KD, editor. Subphylum sarcomastigophora: Superclass sarcodina, class rhizopodea: Order amoebida. In: Parasitology (Protozoology and Helminthology) in Relation to Clinical Medicine. 12th ed. Kolkata, India: SreeSaraswaty Press Ltd; 2001. p. 14-36.
3. Petri WA, Haque R. Entamoeba histolytica brain abscess. Handb Clin Neurol. 2013;114:147-52. doi: 10.1016/B978-0-444-53490-3.00009-1.
4. Viriyavejakul P, Riganti M. Undiagnosed amebic brain abscess. Southeast Asian J Trop Med Public Health 2009;40:1183-7.
5. Maldonado-Barrera CA, Campos-Esparza Mdel R, Muñoz-Fernández L, Victoria-Hernández JA, Campos-Rodríguez R, Talamás-Rohana P, et al. Clinical case of cerebral amebiasis caused by E. histolytica. Parasitol Res 2012;110:1291-6. doi: 10.1007/s00436-011-2617-8. Epub 2011 Aug 26.
6. Ohnishi K, Murata M, Kojima H, Takemura N, Tsuchida T, Tachibana H. Brain abscess due to infection with Entamoeba histolytica. Am J Trop Med Hyg 1994;51:180-2.
7. Ximénez C, Morán P, Rojas L, Valadez A, Gómez A. Reassessment of the epidemiology of amoebiasis: State of the art. Infect Genet Evol 2009;9:1023-32.
8. Gupta KB, Manchanda M, Chaudhary U, Verma M. Superior vena cava syndrome caused by pulmonary amoebic abscess. Indian J Chest Dis Allied Sci 2006;48:275-7.
9. Stanley SL Jr. Amoebiasis. Lancet 2003;361:1025-34.
10. Kothiwala AK, S Rai HI, Garg K, Singh M, Singh P, Sharma BS, Sood R. Giant anterior interhemispheric fissure amoebic abscess: A rare case. Neurol India 2018;66:548-51.
11. Sayhan Emil S, Altinel D, Bayol U, Ozcolpan OO, Tan A, Ganiusmen O. Indian J Pediatr 2008;75:1078-80. https://doi.org/10.1007/s12098-008-0182-7
12. Tamer GS, Öncel S, Gökbulut S, Arisoy ES. A rare case of multilocus brain abscess due to Entamoeba histolytica infection in a child. Saudi Med J 2015;36:356-8.
13. Sundaram C, Prasad BC, Bhaskar G, Lakshmi V, Murthy JM. Brain abscess due to Entamoeba histolytica. J Assoc Physicians India 2004;52:251-2.
14. Sarica FB, Tufan K, Cekinmez M, Erdogan B, Altinors MN. A Rare But Fatal Case of Granulomatous Amebic Encephalitis with Brain Abscess: The First Case Reported from Turkey Turkish Neurosurgery 2009;19:256-9.
15. Morishita A, Yamamoto H, Aihara H. A case of amebic brain abscess. [Article in Japanese] No Shinkei Geka. 2007;35:919-25.
Published
2019-03-27
Issue
Section
Case Report
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