Meningoencephalitis caused by Acanthamoeba spp . is a rare opportunistic infection, difficult to diagnose and difficult to treat, which causes death in almost all cases. We report the neuropathologic findings of a 16-year-old girl with systemic lupus erythematosus (SLE) treated with immunosuppression who died of fulminant Acanthamoeba meningoencephalitis. Neuropathologic examination revealed multiple supratentorial and infratentorial hemorrhagic necrotizing lesions with encephalitis and vasculitis with mixed inflammatory infiltrates, fibrinoid necrosis of vessel walls, and local leptomeningitis. Acanthamoeba in the lesions may be misinterpreted as macrophages. Taking them into differential diagnostic consideration, cytological differences should be detected, and relevant additional stains for reliable differentiation of these cells can be performed. To our knowledge, this is the first published case of Acanthamoeba meningoencephalitis in a patient with SLE in Germany.

译文

棘阿米巴引起的脑膜脑炎。是一种罕见的机会性感染,诊断困难,治疗困难,几乎导致所有病例死亡。我们报告了一名接受免疫抑制治疗的16岁系统性红斑狼疮 (SLE) 女孩的神经病理学发现,该女孩死于暴发性棘阿米巴脑膜脑炎。神经病理学检查发现多发性幕上和幕下出血性坏死性病变伴脑炎和血管炎混合炎性浸润,血管壁纤维蛋白样坏死和局部软脑膜炎。病变中的棘阿米巴可能被误解为巨噬细胞。考虑到它们的鉴别诊断,应检测细胞学差异,并可以进行相关的附加染色以可靠地分化这些细胞。据我们所知,这是德国SLE患者中第一例发表的棘阿米巴脑膜脑炎病例。

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