Acanthamoebiasis

Classification according to ICD-10
B60.1	Acanthamoebiasis
H19.2 *	Keratitis and keratoconjunctivitis in other infectious and parasitic diseases classified elsewhere
H13.1 *	Conjunctivitis in infectious and parasitic diseases classified elsewhere
A06.6 +	Amoeba brain abscess
G07 *	Intracranial and Intraspinal Abscesses and Granulomas in Diseases Classified Elsewhere
ICD-10 online (WHO version 2019)

Acanthamoebiasis is a worldwide common disease caused by Acanthamoeba ( Acantamoeba sp.). It occurs as granulomatous amoebic encephalitis (GAE) or acanthamoebic keratitis .

infection

The disease is triggered by acanthamoeba , which enter the body through skin lesions, spread through the blood system and can affect the central nervous system . There is also the possibility that the lungs are used to enter the body (GAE). If the disease occurs in the eye, it is usually due to soft contact lenses contaminated with the pathogen (acanthamoebic keratitis), often in connection with trauma and a damp environment.

Symptoms

The incubation period for GAE can be anywhere from two weeks to several months. After a rather insidious onset, the disease is characterized by memory disorders, cerebral seizures or fever and headaches, as well as hemiplegia . Death can occur a few days to months after the onset of the disease.

In acanthamoeba keratitis, a foreign body sensation occurs first in the eye. There is an acute onset with barely bearable intermittent shooting pain, eye tears, eyelid cramps and blurred vision, whereby the symptoms can appear and disappear at intervals. The vision deteriorates continuously over the course of weeks. As the disease progresses, the eye becomes inflamed and pressure increases in the eye. The examination reveals a corneal ulcer without a slimy coating, a ring-shaped central corneal opacity (swollen in this area) with overlying erosion.

therapy

As of 1998 Not much is known about a therapy for GAE, since a corresponding diagnosis is often only made after death through brain biopsies. However, there are preparations that show in vitro effects (especially pentamidine , ketoconazole and flucytosine ). Acanthamoebic keratitis can be recognized early. Miconazole, propamidine and pentamidine are available as local therapeutic agents. Surgical intervention is possible.

literature

B. Reinhardt, M. Dietrich, H. Schmitz, K. Janitschke, K. Tintelnot, M. Niederig: Profiles of rare and "imported" infectious agents. An information brochure from the Robert Koch Institute. Robert Koch Institute - Press and Public Relations Section, Berlin 1998, ISBN 3-89606-028-7 .

Web links

Amoebic Keratitis , T. Reinhard, University Eye Clinic Freiburg (PDF file; 995 kB)
Acanthamoeba Infection Fact Sheet
New York Times: 2 Kidney Recipients Contract Brain Disease From Donor

Individual evidence

^ Marianne Abele-Horn: Antimicrobial Therapy. Decision support for the treatment and prophylaxis of infectious diseases. With the collaboration of Werner Heinz, Hartwig Klinker, Johann Schurz and August Stich, 2nd, revised and expanded edition. Peter Wiehl, Marburg 2009, ISBN 978-3-927219-14-4 , p. 289.

[1] Marianne Abele-Horn: Antimicrobial Therapy. Decision support for the treatment and prophylaxis of infectious diseases. With the collaboration of Werner Heinz, Hartwig Klinker, Johann Schurz and August Stich, 2nd, revised and expanded edition. Peter Wiehl, Marburg 2009, ISBN 978-3-927219-14-4 , p. 289.