Past history of aplastic anaemia, bone marrow transplantation and curatively resected gastric cancer (T1N0M0) presented with headache, fever and impaired consciousness.
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On T2 weighted images two pseudotumoural masses are seen in the left parietal and occipital lobes with low signal rim surrounding. T2* shows low signal around masses indicating haemorrhagic change.
Postmortem histopathology confirmed the diagnosis of amoebic encephalitis from Acanthamoeba spp.
Amoebic encephalitis is a rare and usually fatal disease that occurs almost exclusively in patients with immunosuppression. Amoebae including Acanthamoeba spp, Balamuthia mandrillaris, Naegleria fowleri and Sappinia pedata have all caused encephalitis in reported cases worldwide. There are currently no effective treatments.
Imaging findings are nonspecific and rarely described in literature, but can include:
- multiple parenchymal lesions
- pseudotumoural lesions
- meningeal exudates
- haemorrhagic infarcts
Images and case thanks to Osaka University Hospital
- Mayer PL, Larkin JA, Hennessy JM. Amebic encephalitis. Surgical Neurology International. 2011;2:50. doi:10.4103/2152-7806.80115.
- Singh P, Kochhar R, Vashishta RK, Khandelwal N, Prabhakar S, Mohindra S, Singhi P. Amebic meningoencephalitis: spectrum of imaging findings. AJNR Am J Neuroradiol. 2006 Jun-Jul;27(6):1217-21. http://www.ncbi.nlm.nih.gov/pubmed/16775267