Cutaneous acanthamebiasis infection in immunocompetent and immunocompromised patients

Authors


Alex G. Ortega-Loayza, md
Department of Medicine
University of North Carolina at Chapel Hill
99 Manning Dr, Campus Box 7075 Chapel
Hill, NC 27599
E-mail: aortega@med.unc.edu

Abstract

Background  Cutaneous acanthamebiasis is a rare infection and few patients have been reported worldwide.

Methods  Observational and descriptive study carried out from March 1996 to February 2006 in patients with diagnosis of cutaneous free-living amebic infection caused by Acanthamoeba spp. The patients were diagnosed at the Dos de Mayo National Hospital (Lima-Peru) where skin biopsies, histopathologic studies and cultures were performed. The clinical and epidemiologic characteristics, diagnosis, treatment and evolution were recorded in a survey.

Results  Five patients with cutaneous free-living amebic infection caused by Acanthamoeba spp. were identified. Skin lesions were ulceronecrotic (four patients), an infiltrative bluish plaque (one patient), and a periorbital tumor (one patient). Three patients were positive for human immunodeficiency virus (HIV), had only cutaneous involvement, and died of opportunistic infections. The two immunocompetent patients developed Acanthamoeba granulomatous encephalitis and meningoencephalitis that progressed to intracranial hypertension and death.

Conclusion  The clinical manifestations of cutaneous free-living amebic infection caused by Acanthamoeba spp. appear to vary according to the underlying immunologic status.

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