This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (39)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

A Report of Five Cases and a Review of the Literature

George J. Murakawa, MD; Timothy McCalmont, MD; Jeffrey Altman, MD; Gladys H. Telang, MD; Mark D. Hoffman, MD; Gary R. Kantor, MD; Timothy G. Berger, MD

Arch Dermatol. 1995;131(11):1291-1296.

Abstract
Background
Acanthamoeba and Leptomyxida are free-living amebae that cause granulomatous amebic encephalitis, a rare, slowly progressive, fatal neurologic process seen in immunosuppressed hosts. In addition, these organisms produce disseminated cutaneous lesions and involve other organs, particularly in patients with the acquired immunodeficiency syndrome (AIDS).

Results
We report five cases of disseminated acanthamebiasis in patients with AIDS, each with cutaneous manifestations but lacking central nervous system involvement. The median CD4⁺ T-cell count was 0.024x10⁹/L. Skin lesions included pustules, subcutaneous and deep dermal nodules, and ulcers, most often seen on the extremities and face. Histopathologically, both pustular and vasculitic changes were observed; in all cases, the microscopic identification of organisms was difficult because of the macrophagelike appearance of the microbes in routine sections.

Conclusions
Skin lesions are the most commonly reported presentation of infections caused by Acanthamoeba and Leptomyxida organisms in patients with AIDS, a minority of whom have central nervous system manifestations. A high index of suspicion is necessary for both the dermatologist and the dermatopathologist. Prognosis is guarded, but early treatment using a combination of intravenous pentamidine and oral fluconazole, sulfadiazine, and flucytosine may be beneficial.

(Arch Dermatol. 1995;131:1291-1296)

Author Affiliations
From the Departments of Dermatology and Pathology, University of California at San Francisco (Drs Murakawa, McCalmont, and Berger); Department of Dermatology, Rush-Presbyterian—St Luke's Medical Center, Chicago, Ill (Drs Altman and Hoffman); and the Department of Dermatology, Hahnemann University Hospital, Philadelphia, Pa (Drs Telang and Kantor).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Multiplex Real-Time PCR Assay for Simultaneous Detection of Acanthamoeba spp., Balamuthia mandrillaris, and Naegleria fowleri.
Qvarnstrom et al.
J. Clin. Microbiol. 2006;44:3589-3595.
ABSTRACT | FULL TEXT  

Tender Subcutaneous Nodules in a Patient With AIDS--Diagnosis
Arch Dermatol 2003;139:1647-1652.
FULL TEXT  

Acanthamoeba spp. as Agents of Disease in Humans
Marciano-Cabral and Cabral
Clin. Microbiol. Rev. 2003;16:273-307.
ABSTRACT | FULL TEXT  

Granulomatous Amebic Encephalitis in a Patient with AIDS: Isolation of Acanthamoeba sp. Group II from Brain Tissue and Successful Treatment with Sulfadiazine and Fluconazole
Seijo Martinez et al.
J. Clin. Microbiol. 2000;38:3892-3895.
ABSTRACT | FULL TEXT  

Fluorescent Oligonucleotide Probes for Clinical and Environmental Detection of Acanthamoeba and the T4 18S rRNA Gene Sequence Type
Stothard et al.
J. Clin. Microbiol. 1999;37:2687-2693.
ABSTRACT | FULL TEXT