infectious diseases
Granulomatous Amebic Encephalitis
Key Points
Granulomatous amebic encephalitis is a very rare, usually fatal, CNS infection. Acanthamoebaencephalitis occurs almost entirely in immunocompromised or otherwise debilitated patients, butB. mandrillarismay infect healthy hosts. Do head CT or MRI, both with contrast; do CSF tests to exclude other causes; biopsy skin lesions, if present, or sometimes the brain to check for amebas. Consult with the CDC about diagnostic testing and optimal treatment. Treat withmiltefosineplus other antiparasitic drugs (eg,pentamidine,sulfadiazine,flucytosine, an azole). 