SUCCESSFUL TREATMENT OF DISSEMINATED ACANTHAMOEBA INFECTION IN AN IMMUNOCOMPROMISED PATIENT

Disseminated acanthamoeba infection, an amebic infection characterized by granulomatous infiltrates in the brain and skin, usually occurs in immunocompromised or debilitated patients and generally progresses to death. There has been no effective therapy. We report on a patient who had undergone renal transplantation and was receiving triple immunosuppressive therapy when widespread granulomatous skin lesions caused by Acanthamoeba rhysodes developed. Antimicrobial therapy was initiated with a four-week course of intravenous pentamidine isethionate, topical chlorhexidine gluconate, and 2 percent ketoconazole cream. The result was a dramatic improvement in the skin lesions. Cyclosporine levels remained stable, but therapy was complicated by signs of. © 1994, Massachusetts Medical Society. All rights reserved.