Neurol Case Rep | Volume 7, Issue 2 | Case Report | Open Access

Challenges in Diagnosing and Treating GAE: A Case Report of Fatal Acanthamoeba spp. Encephalitis in an Immunocompetent Patient

Khaoula B^1,2*, Louhab N^1,2, Safae Z^1,2, Chraa M^1,2 and Najib K^1,2

¹Department of Neurology, Mohammed VI University Hospital, Marrakech, Morocco ²Marrakech Medical School, Cadi Ayyad University, Marrakech, Morocco

^*Correspondance to: Khaoula Belaidi 

Abstract

Granulomatous Amoebic Encephalitis (GAE) is a rare but fatal infection of the central nervous system with a high mortality rate, due to Free-Living Amoebae (FLA) that are pathogenic to humans and ubiquitous in environment. In this paper, we report the case of an immunocompetent adult female with no relevant medical history who presented acute symptoms resembling a stroke: Altered mental status, slurred speech, brutal proportional right hemiplegia, facial droop and focal to bilateral Tonic- Clonic seizures all concomitant with high fever. Subsequent Magnetic Resonance Imaging (MRI) of the brain revealed diffuse multiple nodular lesions both above and below the tentorium. The initial Cerebrospinal Fluid (CSF) profile was of no great significance however microscopic examination of CSF was able to identify the presence of amoeboid microorganisms and cyst formation, suggestive of a telluric amoeba’s infection. The patient was then treated with a combination of fluconazole and trimethoprim-sulfamethoxazole but her neurological state kept on declining until she passed away from GAE. In our case report we highlight the difficulties clinicians encounter handling this disease, since the clinical and radiological presentation are non-specific, additionally to the absence of clear therapeutic guidelines after diagnosis. Our findings point up the urgent need for more precise diagnostic criteria and comprehensive treatment protocols to improve patient outcomes.

Keywords:

Granulomatous Amoebic Encephalitis (GAE); Free-living amoebae (FLA); Acanthamoeba spp.

Citation:

Khaoula B, Louhab N, Safae Z, Chraa M, Najib K. Challenges in Diagnosing and Treating GAE: A Case Report of Fatal Acanthamoeba spp. Encephalitis in an Immunocompetent Patient. Neurol Case Rep. 2024; 7(2): 1049..