Volume 81, Issue 2
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645


We report the first case of granulomatous amebic encephalitis caused by in a previously healthy farmer in Taiwan who fell into a ditch. The DNA amplicons of amebas identified by polymerase chain reaction in the cerebrospinal fluid specimen and the ditch water specimens were identical and shared strong homology with . He survived after treatment with amphotericin B, rifampin, and corticosteroids.


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  1. Ma P, Visvesvara GS, Martinez AJ, Theodore FH, Dagget PM, Sawyer TK, 1990. Naeglaria and Acanthamoeba infections. Rev Infect Dis 12 : 490–513.
  2. Marciano-Cabral F, 2003. Acanthamoeba spp. as agents of disease in humans. Clin Microbiol Rev 16 : 273–307.
  3. Schuster FL, 2004. Free-living amoebae as opportunistic and non-opportunistic pathogens of humans and animals. Int J Parasitol 34 : 1001–1027.
  4. Qvarnstrom Y, Visvesvara GS, Sriram R, da Silva AJ, 2006. Multiplex real-time PCR assay for simultaneous detection of Acanthamoeba spp., Balamuthia mandrillaris, and Naegleria fowleri. J Clin Microbiol 44 : 3589–3595.
  5. Schild M, Gianinazzi C, Gottstein B, Muller N, 2007. PCR-based diagnosis of Naegleria sp. infection in formalin-fixed and paraffin-embedded brain sections. J Clin Microbiol 45 : 564–567.
  6. Schroeder JM, Booton GC, Hay J, Niszl IA, Seal DV, Markus MB, Fuerst PA, Byers TJ, 2001. Use of subgenic 18S ribosomal DNA PCR and sequencing for genus and genotype identification of acanthamoebae from humans with keratitis and from sewage sludge. J Clin Microbiol 39 : 1903–1911.
  7. Higgins DG, Sharp PM, 1988. CLUSTAL: a package for performing multiple sequence alignment on a microcomputer. Gene 73 : 237–244.
  8. Tamura K, Dudley J, Nei M, Kumar S, 2007. MEGA4: molecular evolutionary genetics analysis (MEGA) software version 4.0. Mol Biol Evol 24 : 1596–1599.
  9. Sison JP, Kemper CA, Loveless M, McShane D, Visvesvara GS, Deresinski SC, 1995. Disseminated Acanthamoeba infection in patients with AIDS: case reports and review. Clin Infect Dis 20 : 1207–1216.
  10. Martinez AJ, Visvesvara GS, 1997. Free-living, amphizoic and opportunistic amebas. Brain Pathol 7 : 583–598.
  11. Kidney DD, Kim SH, 1998. CNS infections with free living amebas: neuroimaging findings. AJR Am J Roentgenol 171 : 809–812.
  12. Lalitha MK, Anandi V, Srivastava A, Thomas K, Cherian AM, Chandi SM, 1985. Isolation of Acanthamoeba culbertsoni from a patient with meningitis. J Clin Microbiol 21 : 666–667.
  13. Carter RF, Cullity GJ, Ojeda VJ, Silberstein P, Willaert E, 1981. A fatal case of meningocephalitis due to a free-living ameba of uncertain identity: probably Acanthamoeba sp. Pathology 13 : 51–68.
  14. Walochnik J, Aichelburg A, Assadian O, Steuer A, Visvesvara G, Vetter N, Aspock H, 2008. Granulomatous amoebic encephalitis caused by Acanthamoeba amoebae of genotype T2 in a human immunodeficiency-virus negative patient. J Clin Microbiol 46 : 338–340.
  15. Bloch KC, Schuster FL, 2005. Inability to make a premortem diagnosis of Acanthamoeba species infection in a patient with fatal granulomatous amebic encephalitis. J Clin Microbiol 43 : 3003–3006.
  16. Ferante A, Rowen Kelly B, Thong YH, 1984. In vitro sensitivity of virulent Acanthamoeba culbertsoni to a variety of drugs and antibiotics. Int J Parasitol 14 : 53–56.
  17. Stevens AR, Willaert E, 1980. Drug sensitivity and resistance of four Acanthamoeba species. Trans R Soc Trop Med Hyg 74 : 806–808.
  18. Das SR, Asiri S, el Soofi A, Baer HP, 1991. Protective and curative effects of rifampicin in Acanthamoeba meningitis of the mouse. J Infect Dis 163 : 916–917.
  19. Rowen Kelly B, Ferante A, Thong YH, 1982. The chemotherapeutic value of sulphadiazine in treatment of Acanthamoeba meningoencephalitis in mice. Trans R Soc Trop Med Hyg 76 : 636–638.
  20. Slater CA, Sickel JZ, Visvesvara GS, Pabico RC, Gaspari AA, 1994. Successful treatment of disseminated Acanthamoeba infection in an immunocompromised patient. N Engl J Med 331 : 85–87.

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  • Received : 13 May 2009
  • Accepted : 23 May 2009

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