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Rifampicin (Rifampin)
Published in M. Lindsay Grayson, Sara E. Cosgrove, Suzanne M. Crowe, M. Lindsay Grayson, William Hope, James S. McCarthy, John Mills, Johan W. Mouton, David L. Paterson, Kucers’ The Use of Antibiotics, 2017
C. Alan, C. Street, Tony M. Korman
Primary amoebic meningoencephalitis (PAM) is caused by Naegleria fowleri and is acquired by exposure to the organism in warm water; it is a very rare, rapidly progressive infection with a high fatality rate, and amphotericin B is regarded as the treatment of choice (Hannisch and Hallagan, 1997), with some recent data also supporting the use of miltefisone (see Chapter 199, Miltefosine). Acanathamoeba spp. cause granulomatous amoebic encephalitis (GAE), which is also rare and serious and occurs almost exclusively in immunosuppressed patients such as those with HIV infection or organ transplant recipients. Although in vitro data regarding activity of rifampicin are conflicting (see section 2, Antimicrobial activity), some survivors of PAM and GAE have been treated with rifampicin in combination with amphotericin B, fluconazole, or other agents (Vargas-Zepeda et al., 2005; Fung et al., 2008; Movahedi et al., 2012; Sood et al., 2014).
Acanthamoeba
Published in Dongyou Liu, Laboratory Models for Foodborne Infections, 2017
On the basis of their morphological features, members of the genus Acanthamoeba are placed into three groups (designated Groups I, II, and III). Acanthamoeba Group I consists of five species [e.g., A. astronyxis (T7), A. tubiashi (T8), A. comondani (T9)], which produce large trophozoites of 25–35 μm and cysts (with distinctly stellate endocysts and smooth spherical ectocysts) of >18 μm in size, with cysts that either have four or less arms or more than six arms. This group is mostly environmental and not convincingly associated with infections in humans or animals. Acanthamoeba Group II comprises 10 species such as A. castellanii (T4), A. griffinii (T3), A. hatchetti (T11), A. polyphaga, and A. stevensoni (T11), which produce cysts (with polygonal to stellate endocysts and irregular or wrinkled ectocysts) of <18 μm in size with rounded arms. This group is responsible for the majority of reported human infections [e.g., amebic keratitis (AK), granulomatous amebic encephalitis (GAE), cutaneous acanthamoebiasis, and sinusitis]. Acanthamoeba Group III comprises species A. culbertsoni (T10), A. healyi (T12), A. palestinensis (T1), A. pustulosa (T2), and A. lenticulata (T5), which possess cysts of <15 μm in size (smaller than those of Group II) with three to five points. A. culbertsoni from Group III is a recognized pathogen causing both keratitis and encephalitis [2].
Epidemiology of free-living amoebae in the Philippines: a review and update
Published in Pathogens and Global Health, 2022
Giovanni D. Milanez, Frederick R. Masangkay, Gregorio L. Martin I, Ma. Frieda Z Hapan, Edilberto P. Manahan, Jeffrey Castillo, Panagiotis Karanis
Among the FLAs, the genera belonging to Naegleria, Acanthamoeba, Balamuthia, and Sappinia are considered by the World Health Organization (WHO) as medically important due to the morbidity or mortality reports in humans [16]. The route of cerebral infections for pathogenic FLA, in particular Naegleria spp., is initiated by the entry of the amoeba via the nasal cavity usually upon inhalation of contaminated water [17]. Upon reaching the brain via the cribriform plate, FLAs can mediate cytopathic effects resulting in the inflammation of the brain known as meningitis [18]. Depending on the FLA species or genotype and type of infection, conditions have been referred to as Primary Amoebic Meningoencephalitis (PAM) for Naegleria spp. infections [19], Granulomatous Amoebic Meningoencephalitis (GAE) for Acanthamoeba spp. infection [20], Balamuthia Amoebic Encephalitis (BAE) for Balamuthia mandrillaris infection, and Sappinia Amoebic Encephalitis (SAE) for Sappinia spp. infections [21]. Clinical conditions have almost equal morbidity to mortality ratio due to the rapid progression of the disease following the onset of symptoms [22]. Further, the symptoms presented by FLA-related meningitis mimic viral and bacterial forms, thus, making diagnosis and management of the disease challenging for clinicians and almost always leads to death [23]. Among the FLAs, pathogenic genotypes of Acanthamoeba spp. can inflict extra-cerebral infections like Acanthamoeba keratitis, and in rare cases, disseminated cutaneous infection [24–27].
Granulomatous amoebic encephalitis caused by Acanthamoeba in a patient with AIDS: a challenging diagnosis
Published in Acta Clinica Belgica, 2021
Hsien Lee Lau, Daniela F. De Lima Corvino, Francisco M. Guerra, Amer M. Malik, Paola N. Lichtenberger, Sakir H. Gultekin, Jana M. Ritter, Shantanu Roy, Ibne Karim M. Ali, Jennifer R. Cope, M. Judith D. Post, Jose A. Gonzales Zamora
Acanthamoeba spp. disease can present as granulomatous amoebic encephalitis (GAE), keratitis, dermatitis, pneumonitis, sinusitis, and disseminated infections in patients with immunodeficiencies (HIV/AIDS (human immunodeficiency virus/acquired immune deficiency syndrome), chemotherapy and organ transplantation) [1]. Several free-living amoebas can cause GAE. GAE by Acanthamoeba spp. is primarily seen in immunocompromised individuals, while Balamuthia mandrillaris, another pathogenic free-living amoeba (FLA) can affect both immunocompromised (<40% of cases) and immune competent individuals [2]. The diagnosis is established post-mortem in the large majority of reported cases. Several hundred cases of GAE have been documented with a higher incidence in men [3]. The difficulty in diagnosis is likely multi-factorial; the rarity of GAE, limited availability of diagnostic studies, and non-specific clinical and radiologic presentations. Here, we present a fatal case of Acanthamoeba GAE in a patient with AIDS with a post-mortem diagnosis.
Fulminant acanthamoebic meningoencephalitis in immunocompetent patients: an uncommon entity
Published in British Journal of Neurosurgery, 2022
Lokesh Suresh Nehete, Anil Kumar, Pooja Chavali, Prabhuraj A. R., Bhagavatula Indira Devi
Granulomatous amoebic encephalitis is an opportunistic disease and affects immunologically compromised host. Patients with diabetes mellitus, renal failure, bone marrow failure, hematoproliferative disorders, splenectomy, dysproteinemias, radiotherapy, corticosteroids, chemotherapy and acquired immunodeficiency syndrome are particularly susceptible to infection with it. A few cases, however, have been described from individuals with no obvious signs of immunosuppression, especially from low socioeconomic status. The onset of granulomatous amoebic encephalitis (GAE) is insidious and develops as a chronic disease over several weeks to months.