Journal Article

Disseminated Acanthamebiasis in a Renal Transplant Recipient with Osteomyelitis and Cutaneous Lesions: Case Report and Literature Review

Jordan P. Steinberg, Rene L. Galindo, Edward S. Kraus and Khalil G. Ghanem

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 35, issue 5, pages e43-e49
Published in print September 2002 | ISSN: 1058-4838
Published online September 2002 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/341973
Disseminated Acanthamebiasis in a Renal Transplant Recipient with Osteomyelitis and Cutaneous Lesions: Case Report and Literature Review

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Disseminated acanthamebiasis is a rare disease that occurs predominantly in patients with human immunodeficiency virus (HIV) infection or acquired immunodeficiency syndrome but also in immunosuppressed transplant recipients. Few reports have focused on non—HIV-infected patients, in whom the disease is more likely to go unsuspected and undiagnosed before death. We describe a renal transplant recipient with Acanthamoeba infection and review the literature. The patient presented with osteomyelitis and widespread cutaneous lesions. No causative organism was identified before death, despite multiple biopsies with detailed histological analysis and culture. Disseminated Acanthamoeba infection was diagnosed after death, when cysts were observed in histological examination of sections of skin from autopsy, and trophozoites were found in retrospectively reviewed skin biopsy and surgical bone specimens. In any immunosuppressed patient, skin and/or bone lesions that fail to show improvement with broad-spectrum antibiotic therapy should raise the suspicion for disseminated acanthamebiasis. Early recognition and treatment may improve clinical outcomes.

Journal Article.  3559 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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