First Case of Granulomatous Amebic Encephalitis Caused by Acanthamoeba castellanii in Taiwan

Sheng, Wang‐Huei; Hung, Chien‐Ching; Huang, Huai-Hsuan; Liang, S.-Y.; Cheng, Yu-Jen; Ji, Dar-Der; Chang, Shan-Chwen

doi:10.4269/ajtmh.2009.81.277

Cited by 30 publications

(16 citation statements)

References 19 publications

(21 reference statements)

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“…Identification of the source of the causative Acanthamoeba or other free‐living amoebas could lead to early warning and prevent further human infections in the region. In this case, the GAE patient survived after timely treatment with amphotericin B, rifampin and corticosteroids (Sheng et al. 2009), and help us facilitate this survey.…”

Section: Discussionmentioning

confidence: 93%

“…2005) and granulomatous amoebic encephalitis (GAE). Recently, the first case of GAE in Taiwan was confirmed by the presence of Acanthamoeba DNA in a patient’s cerebrospinal fluid (CSF) (Sheng et al. 2009).…”

Section: Introductionmentioning

confidence: 99%

“…Acanthamoeba is recognized as the causative agent of Acanthamoeba keratitis (AK), which typically follows trauma associated with contact lenses (Alizadeh et al 2005) and granulomatous amoebic encephalitis (GAE). Recently, the first case of GAE in Taiwan was confirmed by the presence of Acanthamoeba DNA in a patient's cerebrospinal fluid (CSF) (Sheng et al 2009). The source and transmission route of AK or GAE has not been well characterized in Taiwan though several cases of AK had been reported (Hsiao et al 2005;Tseng et al 2005;Lin et al 2008).…”

Section: Introductionmentioning

confidence: 99%

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Isolation and identification of Acanthamoeba species related to amoebic encephalitis and nonpathogenic free-living amoeba species from the rice field

Liang¹,

Hsia³

et al. 2010

Journal of Applied Microbiology

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Section: Discussionmentioning

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Isolation and identification of Acanthamoeba species related to amoebic encephalitis and nonpathogenic free-living amoeba species from the rice field

Liang¹,

Hsia³

et al. 2010

Journal of Applied Microbiology

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“…In Taiwan, the first case of Acanthamoeba keratitis was reported in 1989 (Tseng et al 1989), and granulomatous amoebic encephalitis was confirmed in 2009 (Sheng et al 2009) by the presence of Acanthamoeba DNA in a patient cerebrospinal fluid. In recent years, the source of Acanthamoeba, Hartmannella, Naegleria and their intracellular parasites from spring water samples had been reported in Taiwan (Hsu et al 2009a, b;Huang and Hsu 2010a, b).…”

Section: Introductionmentioning

confidence: 93%

Molecular detection and comparison of Acanthamoeba genotypes in different functions of watersheds in Taiwan

Kao

Hsu

Chen

et al. 2011

Environ Monit Assess

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The protistan genus Acanthamoeba is a free-living amoeba existing in various environments. Within this protistan genus, there are some species recognized as potential human pathogens, which may cause granulomatous amoebic encephalitis, Acanthamoeba keratitis and chronic granulomatous lesions of the skin. In this study, 211 water samples were collected from two watersheds in southern Taiwan. We detected Acanthamoeba based on the PCR amplification with a genus-specific primer pair and investigation of Acanthamoeba in Puzih River and Kaoping River in southern Taiwan. Acanthamoeba species were detected in 34 (16.1%) samples. The presence or absence of Acanthamoeba within the water samples showed significant difference with the levels of water temperature and total coliforms. The most frequently identified Acanthamoeba genotype was T4 (n = 19), followed by T5 (n = 8), and then T15 (n = 3). Genotype T6, T7/T8, T11 and T12 were all detected once. Genotype T4, T5, T6, T11 and T15 of Acanthamoeba are responsible for Acanthamoeba keratitis and should be considered a potential health threat associated with human activities in environmental surface water watersheds.

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“…We evaluated the polyene macrolide corifungin versus Acanthamoeba because an earlier study showed that it effectively killed another free-living ameba, Naegleria fowleri, with better efficacy than amphotericin B (24). Previous studies reported that a combination of amphotericin B and a second drug was effective in eradicating a skin infection and GAE caused by Acanthamoeba (25,26). Amphotericin B has significant toxicity and is a hydrophobic molecule with negligible solubility in aqueous solution (27).…”

Section: Discussionmentioning

confidence: 99%

In Vitro Efficacy of Corifungin against Acanthamoeba castellanii Trophozoites and Cysts

Debnath

Tunac²,

Silva-Olivares

et al. 2014

Antimicrob Agents Chemother

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cPainful blinding keratitis and fatal granulomatous amebic encephalitis are caused by the free-living amebae Acanthamoeba spp. Several prescription eye medications are used to treat Acanthamoeba keratitis, but the infection can be difficult to control because of recurrence of infection. For the treatment of encephalitis, no single drug was found useful, and in spite of the use of a combination of multiple drugs, the mortality rate remains high. Therefore, efficient, novel drugs are urgently needed for the treatment of amebic keratitis and granulomatous amebic encephalitis. In this study, we identified corifungin, a water-soluble polyene macrolide, as amebicidal. In vitro, it was effective against both the trophozoites and the cysts. Transmission electron microscopy of Acanthamoeba castellanii incubated with corifungin showed the presence of swollen mitochondria, electrondense granules, degeneration of cytoplasm architecture, and loss of nuclear chromatin structure. These changes were followed by lysis of amebae. Corifungin also induced the encystment process of A. castellanii. There were alterations in the cyst cell wall followed by lysis of the cysts. Corifungin is a promising therapeutic option for keratitis and granulomatous amebic encephalitis. Free-living Acanthamoeba spp. cause keratitis, a serious eye infection that can occur in healthy individuals wearing contact lenses, as well as chronic granulomatous amebic encephalitis (GAE) leading to death in immunocompromised persons. Acanthamoeba has a worldwide distribution and is the most common ameba found in the environment. Coincident with the number of Acanthamoeba keratitis cases in the United States has been an increase in developing countries. Wearing of contact lenses is now recognized as the leading risk factor for keratitis (1-3). In the United States, the estimated number of keratitis cases is 1.36 per million contact lens wearers (4, 5). GAE is a relatively rare disease. Approximately 150 cases have been reported worldwide (5). GAE results from inhalation of amebae through the nasal cavities and lungs, or introduction through skin lesions followed by access to the central nervous system by hematogenous spread or through the olfactory neuroepithelium (6). Clinical manifestations include headache, fever, nausea, vomiting, behavioral changes, stiff neck, lethargy, increased intracranial pressure, and, in the later stage, loss of consciousness, seizures, coma, and death (7-9).The drugs recommended for the treatment of Acanthamoeba keratitis include polyhexamethylene biguanide (0.02%) or chlorhexidine (0.02%) along with a diamidine (either 0.1% propamidine or 0.1% hexamidine) (10). Corticosteroids are applied topically to control corneal inflammation, pain, and scleritis, particularly following keratoplasty (11). While this antimicrobial treatment can kill the trophozoites, the resistance of Acanthamoeba cysts to antimicrobials can lead to the recurrence of keratitis. For GAE, combination therapies were found more successful than single-drug therapies, a...

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First Case of Granulomatous Amebic Encephalitis Caused by Acanthamoeba castellanii in Taiwan

Cited by 30 publications

References 19 publications

Isolation and identification of Acanthamoeba species related to amoebic encephalitis and nonpathogenic free-living amoeba species from the rice field

Isolation and identification of Acanthamoeba species related to amoebic encephalitis and nonpathogenic free-living amoeba species from the rice field

Molecular detection and comparison of Acanthamoeba genotypes in different functions of watersheds in Taiwan

In Vitro Efficacy of Corifungin against Acanthamoeba castellanii Trophozoites and Cysts

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