Infectious Disease Compendium

Acanthamoeba

Microbiology

An amoeba from fresh water. Includes A. astronyxis, A. castellani, A. culbertsoni, A. hatchetti, A. palestinensis, A. polyphaga, A. rhysodes. A cousin of Naeglaria.

Epidemiologic Risks

Swimming in fresh water lakes, it goes up the first cranial nerve and into the brain. Also found in the environment. Ritual nasal rinsing a risk (PubMed), not unlike the use of Neti Pots (PubMed)(PubMed). Here is a suggestion: only squirt sterile water up your nose.

Syndromes

Primary meningitis, granulomatous meningitis in immunoincompetent, keratitis (especially associated with contact lenses (PubMed)) and disseminated cutaneous acanthamebiasis in AIDS and other immunoincompetent patients.

Treatment

Meningitis- Magical thinking includes (PubMed) combining pentamidine PLUS miconazole PLUS TMP/Sulfa PLUS amphotericin B. No matter what you do, the meningitis will prove fatal, or worse, they will survive with permanent brain damage. Similar therapy for disseminated and cutaneous disease. One case was treated with Miltefosine (PubMed). I will leave the treatment of keratitis to opthalmology.

Notes