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30 June 2020 : Case report  Ireland

A Surviving Case of Acanthamoeba Granulomatous Amebic Encephalitis in a Hematopoietic Stem Cell Transplant Recipient

Challenging differential diagnosis, Unusual or unexpected effect of treatment

Niamh A. Keane1DEF*, Louise Marie Lane2C, Emma Canniff3BC, Daniel Hare4D, Simon Doran3BD, Eugene Wallace5E, Siobhan Hutchinson6B, Marie-Louise Healy7E, Brian Hennessy8BC, Jim Meaney3D, Peter Chiodini9D, Brian O’Connell4D, Alan Beausang2CD, Elisabeth Vandenberghe1EF

DOI: 10.12659/AJCR.923219

Am J Case Rep 2020; 21:e923219

Figure 2. Histopathology. (A) Low-power magnification H&E photomicrographs of brain histology. Fragments of grey and white matter showing perivascular and parenchymal chronic inflammation, composed of lymphocytes, macrophages, and microglial cells. Rare multinucleated giant cells are seen (H&E ×10 objective). (B) Low-power magnification H&E photomicrographs of brain histology. Several variably sized aggregates of microglial cells forming microglial nodules are seen (H&E ×10 objective). (C) High-power magnification H&E photomicrographs of brain histology. Multiple rounded organisms are seen. The majority have a well-defined capsule with abundant granular/vacuolated cytoplasm, a round nucleus, and prominent central karyosome, consistent with amoebic trophozoites (blue arrows). Smaller ones have dark nuclei with a wrinkled and rather refractile outer capsule, consistent with amoebic cysts (red arrows) (H&E ×40 objective).

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923