Granulomatous amoebic encephalitis (GAE), also referred to as cerebral amoebiasis, is a rare and usually fatal CNS infection in immunocompromised patients caused by free living amoebae.
As it occurs with other CNS infectious diseases, the clinical presentation could be extremely variable due the location and other associated comorbidities. Patients with GAE have been described with symptoms that include: headache, low fever, seizures, hemiparesis and coma leading to death 2.
It has been considered that the skin and the olfactory neuroepithelium should work as portals of entry, and occasionally, an inflammatory process may be observed at these primary foci 4.
- pressure slightly elevated
- presence of lymphocytes and plasma cells
- glucose levels are usually low
- moderately high protein levels
- PCR of the cerebrospinal fluid can be diagnostic 3
Multifocal parenchymal lesions characterised by foci of chronic granulomatous inflammation centred around arteries and veins and also infiltrating the meninges. Trophozoites and cysts may be found in and around walls of affected blood vessels and also in areas relatively free of inflammation 1,2.
- 1. Ellison D, Love S, Chimelli LMC et-al. Neuropathology. Elsevier Health Sciences. (2012) ISBN:0723437467. Read it at Google Books - Find it at Amazon
- 2. Lu D, Luo L, Xu Q et-al. A clinico-pathological study of granulomatous amoebic encephalitis. Zhonghua Bing Li Xue Za Zhi. 2003;28 (3): 169-73. Pubmed citation
- 3. Solaymani-Mohammadi S, Lam MM, Zunt JR et-al. Entamoeba histolytica encephalitis diagnosed by PCR of cerebrospinal fluid. Trans. R. Soc. Trop. Med. Hyg. 2007;101 (3): 311-3. doi:10.1016/j.trstmh.2006.05.004 - Pubmed citation
- 4. Walochnik J, Aichelburg A, Assadian O et-al. Granulomatous amoebic encephalitis caused by Acanthamoeba amoebae of genotype T2 in a human immunodeficiency virus-negative patient. J. Clin. Microbiol. 2008;46 (1): 338-40. doi:10.1128/JCM.01177-07 - Free text at pubmed - Pubmed citation