30 June 2020>: Articles
A Surviving Case of Acanthamoeba Granulomatous Amebic Encephalitis in a Hematopoietic Stem Cell Transplant Recipient
Challenging differential diagnosis, Unusual or unexpected effect of treatment
Niamh A. Keane D , Louise Marie Lane C , Emma Canniff B , Daniel Hare D , Simon Doran B , Eugene Wallace E , Siobhan Hutchinson B , Marie-Louise Healy E , Brian Hennessy B , Jim Meaney D , Peter Chiodini D , Brian O’Connell D , Alan Beausang C , Elisabeth Vandenberghe E*DOI: 10.12659/AJCR.923219
Am J Case Rep 2020; 21:e923219
Figure 1. Imaging studies. (A) FLAIR images at presentation. Note circumscribed heterogenous 4-cm mass-like lesion in the left occipital lobe (arrows). Note also a 15-mm lesion with similar single characteristics within the medial right frontal lobe (arrow). Further areas of edema are present in the splenium of the corpus callosum and temporal lobe on the left, which correlate with the patient’s alexia without agraphia and right superior quadrantanopia, respectively. FLAIR images are shown. T1, T2, diffusion, and contrast-enhanced imaging modes revealed partial restricted diffusion and enhancement, but these abnormalities are more marked on FLAIR images. (B) FLAIR images following biopsy. Ten days later, there was significant deterioration with extension of the edema into the left temporal lobe and a mild mass effect (arrows). A more circumscribed focus of high signal intensity within the center of the lesion represents hematoma following biopsy. The right frontal lesion is unchanged. (C) FLAIR images at day 140. Follow-up scan 5 months later demonstrates resolution of the edema on the left, with significant dilatation of the posterior horn of the left lateral ventricle, consistent with ex-vacuo dilatation (asterisks). The high signal intensity within the left temporal lobe, which continues around the dilated posterior horn, is well-demarcated and is consistent with gliosis (arrows).