       Document 0249
 DOCN  M9630249
 TI    Disseminated acanthamebiasis in patients with AIDS. A report of five
       cases and a review of the literature.
 DT    9603
 AU    Murakawa GJ; McCalmont T; Altman J; Telang GH; Hoffman MD; Kantor GR;
       Berger TG; Department of Dermatology, University of California at San;
       Francisco, USA.
 SO    Arch Dermatol. 1995 Nov;131(11):1291-6. Unique Identifier : AIDSLINE
       MED/96067816
 AB    BACKGROUND: Acanthamoeba and Leptomyxida are free-living amebae that
       cause granulomatous amebic encephalitis, a rare, slowly progressive,
       fatal neurologic process seen in immunosuppressed hosts. In addition,
       these organisms produce disseminated cutaneous lesions and involve other
       organs, particularly in patients with the acquired immunodeficiency
       syndrome (AIDS). RESULTS: We report five cases of disseminated
       acanthamebiasis in patients with AIDS, each with cutaneous
       manifestations but lacking central nervous system involvement. The
       medial CD4+ T-cell count was 0.024 x 10(9)/L. Skin lesions included
       pustules, subcutaneous and deep dermal nodules, and ulcers, most often
       seen on the extremities and face. Histopathologically, both pustular and
       vasculitic changes were observed; in all cases, the microscopic
       identification of organisms was difficult because of the macrophagelike
       appearance of the microbes in routine sections. CONCLUSIONS: Skin
       lesions are the most common reported presentation of infections caused
       by Acanthamoeba and Leptomyxida organisms in patients with AIDS, a
       minority of whom have central nervous system manifestations. A high
       index of suspicion is necessary for both the dermatologist and the
       dermatopathologist. Prognosis is guarded, but early treatment using a
       combination of intravenous pentamidine and oral fluconazole,
       sulfadiazine, and flucytosine may be beneficial.
 DE    *Acanthamoeba  Acquired Immunodeficiency Syndrome/*COMPLICATIONS  Adult
       Amebiasis/*COMPLICATIONS/PATHOLOGY  Animal  Case Report  Human  Male
       Middle Age  Skin Diseases, Parasitic/*COMPLICATIONS/PATHOLOGY  JOURNAL
       ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

