Unexpected Postmortem Diagnosis of Acanthamoeba Meningoencephalitis Following Allogeneic Peripheral Blood Stem Cell Transplantation

• Published in: American journal of transplantation Vol. 8; no. 7; pp. 1562 - 1566
• Main Authors: Pemán, J., Jarque, I., Frasquet, J., Alberola, C., Salavert, M., Sanz, J., Gomila, B., Esteban, G.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.07.2008; Blackwell
• Subjects: Acanthamoeba; Acanthamoeba spp; allogeneic stem cell transplantation; Amebiasis - cerebrospinal fluid; Amebiasis - diagnosis; Animals; autopsy; Biological and medical sciences; Humans; Medical sciences; meningoencephalitis; Meningoencephalitis - cerebrospinal fluid; Meningoencephalitis - diagnosis; Peripheral Blood Stem Cell Transplantation - adverse effects; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Protozoa; Nervous system diseases; Lobosea; Acanthamoeba spp; Stem cell; Postmortem; Hematopoietic cell; Homograft; Blood; Meningoencephalitis; allogeneic stem cell transplantation; Autopsy; Acanthamoeba; Central nervous system disease; Graft; Diagnosis
• ISSN: 1600-6135; 1600-6143
• DOI: 10.1111/j.1600-6143.2008.02270.x

Meningoencephalitis caused by pathogenic free‐living amebas is usually fatal. Only a few cases of Acanthamoeba meningoencephalitis, diagnosed at autopsy, have been reported following hematopoietic stem cell transplantation. We here report a case of Acanthamoeba meningoencephalitis following allogeneic peripheral blood stem cell transplantation with rapidly evolving neurologic symptoms that remained unexplained. Magnetic resonance imaging failed to show brain lesions and cerebrospinal fluid was negative for microbiological cultures. Definite diagnosis was an unexpected autopsy finding. As overall and teaching hospital autopsy rates are declining worldwide, we must emphasize the need of autopsy exams if we want to improve our knowledge as the best way to care for our patients. This rare but fatal infectious complication of transplantation was diagnosed at autopsy.