Fulminant Disseminating Fatal Granulomatous Amebic Encephalitis: The First Case Report in an Immunocompetent Patient in South Korea
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초록
Central nervous system infections caused by free-living amoeba are very rare, but often fatal. The typical image findings of amebicmeningoencephalitis are non-specific, showing ring-like enhancement. We report the first case of fulminant disseminatingfatal granulomatous amebic encephalitis caused by Balamuthia mandrillaris in an immunocompetent patient in South Korea. Our case exhibited two interesting features: one was the unusual clinical course and the other was additional image findings. Magnetic resonance imaging revealed a rim-enhancing lesion with intralesional blooming dark signal intensity on susceptibilityweighted imaging and low signal intensity on diffusion weighted images and on apparent diffusion coefficient maps. Differentialdiagnosis was started from a tumor or non-tumorous lesion, and diagnosis was difficult due to the rarity of the disease. Followingthe clinical and diagnostic courses of our case, we recommend inspecting image findings of granulomatous amebic encephalitisfor early diagnosis.
Abstract
Central nervous system infections caused by free-living amoeba are very rare, but often fatal. The typical image findings of amebicmeningoencephalitis are non-specific, showing ring-like enhancement. We report the first case of fulminant disseminatingfatal granulomatous amebic encephalitis caused by Balamuthia mandrillaris in an immunocompetent patient in South Korea. Our case exhibited two interesting features: one was the unusual clinical course and the other was additional image findings. Magnetic resonance imaging revealed a rim-enhancing lesion with intralesional blooming dark signal intensity on susceptibilityweighted imaging and low signal intensity on diffusion weighted images and on apparent diffusion coefficient maps. Differentialdiagnosis was started from a tumor or non-tumorous lesion, and diagnosis was difficult due to the rarity of the disease. Followingthe clinical and diagnostic courses of our case, we recommend inspecting image findings of granulomatous amebic encephalitisfor early diagnosis.
참고문헌 (10)
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