Disseminated Acanthamoeba Infection Presenting With Cutaneous Lesions in an Immunocompromised Patient: A Case Report, Review of Histomorphologic Findings, and Potential Diagnostic Pitfalls

American Journal of Clinical Pathology
Annie O MorrisonColleen S Kraft

Abstract

Free-living amoebas are exceedingly rare causes of cutaneous infections and present unique diagnostic and therapeutic challenges. We describe a case of disseminated acanthamoebiasis with cutaneous manifestations and summarize additional diagnostic, prognostic, and therapeutic highlights. A 58-year-old man with relapsed chronic lymphocytic leukemia had several weeks of progressive, painful ulcerations on the forehead, arms, abdomen, and thighs. A biopsy was performed for histopathologic evaluation. The biopsy specimen showed inflammatory infiltrate with abscess formation involving the epidermis, dermis, and subcutis. Scattered cells showed nuclei with a prominent central karyosome, dispersed chromatin, and either abundant foamy basophilic cytoplasm or two well-demarcated cytoplasmic walls. Acanthamoeba species was confirmed by polymerase chain reaction from the formalin-fixed, paraffin-embedded tissue. Cutaneous lesions from acanthamoebiasis are exceptionally rare but should be included in the differential diagnosis of necrotic cutaneous lesions in immunocompromised patients. Although infrequently encountered, pathologists need to be aware of the morphologic features of free-living amoebas. Immunohistochemical and molecular stud...Continue Reading

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Citations

Jan 20, 2018·Advances in Anatomic Pathology·Andrew P Norgan, Bobbi S Pritt
Sep 25, 2020·PLoS Neglected Tropical Diseases·Christopher A RiceDennis E Kyle
Nov 23, 2017·Environmental Health and Preventive Medicine·Yinghua XuanShanzi Zheng
Sep 22, 2018·Parasites & Vectors·Natalia Łanocha-ArendarczykDanuta Kosik-Bogacka
Nov 28, 2017·Parasitology Research·Daniele Corsaro, Danielle Venditti
Oct 24, 2020·Journal of Water and Health·Lea D BallaresGiovanni D Milanez
Aug 23, 2021·International Journal of Antimicrobial Agents·Alvie Loufouma MbouakaJulia Walochnik

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