OSPE GAE

Question 1

case

Answer 1

renal transplantation presented 6 months after transplantation with depressed level of consciousness.
-Imaging of the head with computerized tomography showed an enhancing lesion suspicious for brain abscess.
* He does not go out of the house since transplant has been done, neither does he use the swimming pool .
* He was taking mycophenolate and tacrolimus for his renal allograft

Question 2

CSF study

Answer 2

• Mild pleocytosis with lymphocytosis
• Moderately elevated protein
• Low glucose.

Question 3

MRI

Answer 3

intracranial masses in the
left frontal lobe.

Question 4

microscopy

Answer 4

wet mount - Acanthamoeba sp
characteristicspine-like pseudopodia

Giemsa stained brain biopsy:Cysts are double-walled

Question 5

State the TWO different stages of the organism which you can identify from the images.

Answer 5

Trophozoite & Cyst

Question 6

How do humans contract this infection?

Answer 6

Usually act as opportunistic pathogens which initially cause pneumonitis or dermal ulcerations in immunocompromised / debilitated individuals. From these lesions the amoebas may spread to the brain to cause an insidious, slowly progressive, and usually fatal encephalitis called granulomatous amebic encephalitis.

Question 7

What are the other clinical presentations caused by this organism?

Answer 7

Ulcerating keratitis, which is often associated with the use of improperly sterilized contact lenses.

Question 8

What is the risk factor in this patient ?

Answer 8

Post renal transplant, on immunosupressants

Question 9

Name TWO other protozoa that can cause CNS disease.

Answer 9

Naegleria fowleri, Toxoplasma gondii, Plasmodium falciparum, Trypanosoma gambiense