Encefalitis por ameba de vida libre

Encefalitis amebiana

Abstract

Granulomatous amoebic encephalitis is a disease considered atypical due to the low incidence since it was described, however, as diagnostic methods have progressed, in retrospect, the presence of this disease has been described since the beginning of the 20^th century, identifying Acanthamoeba spp. and Balamuthia mandrillaris as the most common agents.

A disease that is difficult to diagnose due to the wide clinical range that it can present, being the anatomical site within the central nervous system that will determine these characteristics. High diagnostic suspicion will be the one that will determine the opportune diagnosis, although in its majority with fatal outcome for the patient.

The clinical case of a 26 year old male patient from the city of Durang, México, with no significant history, of brick occupation, who suffers a blow with a brick in the naso-orbital región, follows, entering our hospital on the third day of the event with a diagnosis of left periorbital and nasal cellulitis, progressing with mild headache, left fasciocorporeal hemiparesis, left upper limb parestesia, diplopia, and postural vértigo.

Imaging studies were performed observing heterogeneous lesions in the occipital lobe, left cerebellar hemisphere and brain stem; excision of the cerebellar tumor lesión being carried out, with pathological study, reporting granulomatous encephalitis due to the presence of free-living amoeba. The patient progresses to face-caudal deterioration, declaring his death after 16 days of hospital stay.

Within the state of Durango, Mexico, there are no reported cases of free-living amoeba infection.

Keywords. Amoebic granulomatous encephalitis, free-living amoeba, Acanthamoeba spp, Balamuthia mandrillaris