Granulomatous amoebic encephalitis caused by Acanthamoeba in a patient with AIDS: a challenging diagnosis

Hsien Lee Lau, Daniela F. De Lima Corvino, Francisco M. Guerra, Amer M. Malik, Paola N. Lichtenberger, Sakir H. Gultekin, Jana M. Ritter, Shantanu Roy, Ibne Karim M. Ali, Jennifer R. Cope, M. Judith D. Post, Jose A. Gonzales Zamora

Research output: Contribution to journalArticlepeer-review

12 Scopus citations


Introduction: Acanthamoeba spp. is a ubiquitous free-living amoeba that causes human infections affecting predominantly the cornea and central nervous system. The diagnosis and treatment of Acanthamoeba encephalitis is very challenging. Case summary: A 53-year-old male with HIV/AIDS was admitted for altered mental status and fever. On initial examination, he had left hemianopia with left-sided weakness and numbness. MRI revealed an inflammatory and enhancing parenchymal mass associated with leptomeningeal enhancement in the occipitoparietal lobe containing multiple punctate hemorrhages. He was treated with empiric antibiotics for presumptive toxoplasmosis, brain abscess, fungal infection and tuberculosis with an unremarkable lymphoma work up. Initial brain biopsy studies were unremarkable except for non-specific granulomas and adjacent necrotic tissue. The patient passed away 2.5 months after initial presentation with no diagnosis. Post-mortem testing by the Centers for Disease Control and Prevention (CDC) confirmed the diagnosis of granulomatous amoebic encephalitis (GAE) by visualization with immunohistochemistry staining and PCR. Recovery is rare from GAE likely due to delay in diagnosis. Conclusions: This case illustrates the importance of including GAE into the differential diagnosis of brain mass. We advocate early molecular testing of tissue specimen by the CDC to achieve an appropriate diagnosis, and a multidisciplinary approach for the management of this condition.

Original languageEnglish (US)
Pages (from-to)127-131
Number of pages5
JournalActa Clinica Belgica: International Journal of Clinical and Laboratory Medicine
Issue number2
StatePublished - 2021


  • AIDS
  • Acanthamoeba
  • Granulomatous amoebic encephalitis
  • HIV
  • biopsy

ASJC Scopus subject areas

  • Medicine(all)


Dive into the research topics of 'Granulomatous amoebic encephalitis caused by Acanthamoeba in a patient with AIDS: a challenging diagnosis'. Together they form a unique fingerprint.

Cite this