Minimal Cerebrospinal Concentration of Miltefosine Despite Therapeutic Plasma Levels During the Treatment of Amebic Encephalitis.
Minimal Cerebrospinal Concentration of Miltefosine Despite Therapeutic Plasma Levels During the Treatment of Amebic Encephalitis. Antimicrob Agents Chemother. 2019 Nov 04;: Authors: Monogue ML, Watson D, Alexander JS, Cavuoti D, Doyle LM, Wang MZ, Prokesch BC Abstract Miltefosine is an alkylphosphocholine compound used primarily for treatment of leishmaniasis that also demonstrates in vitro and in vivo anti-amebic activity against Acanthamoeba species. As such, recommendations for treatment of amebic encephalitis generally include miltefosine therapy. Data supports a minimum amebicidal concentration of at least 16 mcg/mL is required for most Acanthamoeba species. Although there is a high level of mortality associated with amebic encephalitis, a paucity of data regarding miltefosine levels in the plasma and cerebrospinal fluid in vivo exists in the literature. We found that despite aggressive dosing (miltefosine 50 mg orally every 6 hours) and therapeutic plasma levels, cerebrospinal fluid miltefosine concentration was negligible in a patient with Acquired Immunodeficiency Syndrome (AIDS) and Acanthamoeba encephalitis. PMID: 31685474 [PubMed - as supplied by publisher]
Publication date: Available online 10 October 2020Source: European Journal of Surgical OncologyAuthor(s): Tetsutaro Miyoshi, Satoshi Yamaguchi, Hiroshi Fujimoto, Shigeru Yoshioka, Masayuki Shiobara, Kazuo Wakatsuki, Kosuke Suda, Kotaro Miyazawa, Toshiaki Aida, Yoshihiro Watanabe, Masayuki Ohtsuka
Publication date: Available online 9 October 2020Source: Neurología (English Edition)Author(s): G. Alvarez Bravo, L. RamióTorrentà
Publication date: October 2020Source: Brain, Behavior, and Immunity, Volume 89Author(s): William H. Walker, O. Hecmarie Meléndez-Fernández, Jordan L. Pascoe, Ning Zhang, A. Courtney DeVries
Authors: Jang Y, Kim DW, Yang KI, Byun JI, Seo JG, No YJ, Kang KW, Kim D, Kim KT, Cho YW, Lee ST, Drug Committee of Korean Epilepsy Society Abstract Autoimmune epilepsy is a newly emerging area of epilepsy. The concept of "autoimmune" as an etiology has recently been revisited thanks to advances in autoimmune encephalitis and precision medicine with immunotherapies. Autoimmune epilepsy presents with specific clinical manifestations, and various diagnostic approaches including cerebrospinal fluid analysis, neuroimaging, and autoantibody tests are essential for its differential diagnosis. The diagnosis is o...
[This Day] Asaba -- Delta State Government has launched the HIV Self-Testing Programme with a vow to scale up all response measures for arresting the relatively high HIV prevalence rate in the state, which places Delta as being among the highest in the country.
In this study, we report the occurrence of the Acanthamoeba belonging to the T4 genotype isolated from nasal and oral swabs of a 15-yr-old man with HIV infection. HIV was confirmed using ELISA kit and RT-PCR assay. The isolated strain showed pathogenic potential using thermo and osmotolerance assays. This patient might be vulnerable to develop GAE or disseminated infections and depending on the immunologic status of the patient, this could be a health threat. Monitoring of such patients, appropriate diagnostic procedures and improved-HIV related care can alter the outcome of such infections. PMID: 28761472 [PubMed]
Conclusion This is the first report of a patient with AIDS and granulomatous amebic encephalitis who survived with medical therapy only.
We describe a case of fatal granulomatous amoebic encephalitis in a patient recently diagnosed to be having SLE, who was receiving corticosteroids, cyclophosphamide, methotrexate, and hydroxychloroquine. The patient presented in an altered sensorium and expired after being hospitalized for 6 days. Postmortem examination of the brain showed extensive areas of necrosis and neutrophilic infiltrate with trophozoites and cysts of Acanthamoeba.
We report a patient in whom GAE secondary to Acanthamoeba was the initial presentation of acquired immunodeficiency syndrome in a 41‐year‐old male, and discuss the FDG positron emission tomography (PET) and magnetic resonance imaging findings that preceded the pathological diagnosis. The PET results provided complementary information when coupled with the MR brain findings. Improved understanding of the clinical and imaging findings of this deadly disease is the best hope for early diagnosis and treatment of this uncommon but deadly disease.