Granulomatous encephalitis, intracranial arteritis, and mycotic aneurysm due to a free-living ameba

Primary amebic meningoencephalitis and granulomatous amebic encephalitis are well recognized clinicopathological entities caused by free-living amebas. Associated arteritis and "mycotic aneurysms" with infiltration of intracranial arteries by lymphocytes, amebic trophozoites and cysts have...

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Bibliographic Details
Published in:Acta neuropathologica 1980, Vol.49 (1), p.7-12
Main Authors: Martínez, A J, Sotelo-Avila, C, Alcalá, H, Willaert, E
Format: Article
Language:English
Subjects:
Amebiasis - pathology
Aneurysm, Infected - pathology
Arteritis - pathology
Brain Stem - pathology
Cerebellum - pathology
Child, Preschool
Encephalitis - pathology
Female
Humans
Intracranial Aneurysm - pathology
Meningoencephalitis - pathology
Spinal Cord - pathology
Thalamus - pathology
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Summary:Primary amebic meningoencephalitis and granulomatous amebic encephalitis are well recognized clinicopathological entities caused by free-living amebas. Associated arteritis and "mycotic aneurysms" with infiltration of intracranial arteries by lymphocytes, amebic trophozoites and cysts have not been previously reported. A 26-month-old girl had a 3-week history of encephalitis, characterized, initially, by vomiting and low-grade fever. Subsequently, she developed ataxia, generalized weakness, lethargy, and esotropia. The first CSF showed 490 RBC/microliters, 705 WBC/microliters with 90% mononuclears. Her pupils reacted briskly to light. Moderate nuchal rigidity, nystagmus, fixed downward gaze, anisocoria, bilateral 6th nerve palsy, left arm monoparesis and left Babinski were present. CAT scan revealed slight symmetrical dilatation of anterior horns of lateral ventricles and an area of abnormal enhancement above the 3rd ventricle. She died 14 days after admission, 5 weeks after onset of symptoms. The brain showed focal necrotizing encephalopathy, involving thalami, cerebellum, brain stem, and cervical and upper thoracic spinal cord. Numerous free-living amebic trophozoites and cysts were present within a chronic granulomatous encephalitis. There were trombosis of basilar, posterior cerebral, and vertebral arteries with profuse chronic panarteritis, fibrinoid necrosis, and mycotic aneurysms.
ISSN:0001-6322
1432-0533
DOI:10.1007/bf00692213