Primary Cutaneous Amebiasis With a Fatal Outcome

Abstract

We report a fatal case of disseminated amebiasis in a young African woman, which initially presented with an ulcerated cutaneous lesion on the left flank. The causative organism was confirmed by examination of a wet drop preparation from the ulcer discharge and by skin biopsy. The patient was not immunosuppressed and was treated unsuccessfully with metronidazole. Postmortem examination revealed the presence of intestinal amebiasis complicated by a liver abscess.

Tropical dermatology: Tropical diseases caused by protozoa

“…Subsequent necrosis of the skin and subjacent tissue leads to undermining, which may be extensive. The result is a well demarcated ulcer with indurated and undermined margins, surrounding erythema, and necrosis at the base with blood-pus discharge 71 (Fig 12, A). These ulcers may be very painful and may enlarge rapidly, reaching a large diameter with interposing normal areas.…”

“…69 The decline in intestinal disease that occurred with the advent of drugs such as metronidazole subsequently led to a decline in cutaneous complications. 70 Cutaneous disease has been reported in different countries around the world, with a predominance in Mexico, 68,70,71 and is a significant cause of parasitic death in developing countries because of poor sanitation and crowded living facilities. Amebiasis is also seen in developed countries where travelers to endemic areas, the institutionalized, the immunosuppressed, and sexually promiscuous homosexual males are identified as high-risk groups.…”

“…65 The lesions caused by external inoculation can be located in other areas, such as the face. 65,71 Clinically, lesions of CA start as deep-seated swellings that rupture and ulcerate. Subsequent necrosis of the skin and subjacent tissue leads to undermining, which may be extensive.…”

“…75 Primary cutaneous amebiasis responds rapidly to treatment but can cause significant morbidity of unrecognized and therefore untreated patients. 71 Therefore, although CA is rare, a high index of suspicion should exist because the disease is easily diagnosed and treated. J AM ACAD DERMATOL VOLUME 60,NUMBER 6 Cutaneous disease caused by free-living amebas, with special emphasis on B mandrillaris…”

Centrofacial Balamuthiasis: case report of a rare cutaneous amebic infection

“…Exposure to these organisms is probably common because of their ubiquitous nature in the natural environment; however, clinically significant skin infection is quite rare. Balamuthia mandrillaris has a predilection for infection of the central facial skin and can also involve the central nervous system (CNS), leading to granulomatous amebic encephalitis (GAE), which is almost invariably fatal . This report describes a patient with a large centrofacial cutaneous lesion due to B .…”