Cutaneous Acanthamoeba Infection Presenting with Granulomatous Vasculitis

• Published in: Skin (Milwood, N.Y.) N.Y.), 2023-03, Vol.7 (2), p.700-704
• Main Authors: Park, Meredith, Googe, Paul, Derebail, Vimal K, Saha, Manish K, Matkovic, Eduard, Cope, Jennifer, Karim, Ibne, Ziemer, Carolyn, Wu, Sam
• Format: Article
• Language: English
• ISSN: 2574-1624; 2574-1624
• DOI: 10.25251/skin.7.2.7

Cutaneous acanthamoebiasis is a rare diagnosis that carries a mortality rate of over 70%. This disease predominantly affects immunocompromised individuals, though infections have been reported in immunocompetent individuals. We report a fatal case of cutaneous Acanthamoeba infection in a patient with granulomatous vasculitis on biopsy, initially thought to be antineutrophil cytoplasmic antibody (ANCA)-negative vasculitis. The patient primarily presented with ulcerating nasal lesions, which subsequently developed into widespread cutaneous lesions. Diagnosis was made months after presentation when amebae were identified during histopathological examination of biopsies obtained repeatedly after the patient failed to improve on standard therapies for ANCA-negative vasculitis. Treatment was unsuccessful, and the patient died due to complications of widespread Acanthamoeba infection. Cutaneous acanthamoebiasis should be considered in the differential diagnosis of granulomatous vasculitis that fails to improve on standard therapies. Early detection and treatment may improve outcomes and reduce mortality in this highly fatal infection.