Another case of canine amoebic meningoencephalitis-the challenges of reaching a rapid diagnosis
Another case of canine amoebic meningoencephalitis-the challenges of reaching a rapid diagnosis
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DOI：
10.1007/s00436-010-2197-z
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发表时间：
2011-04-01
影响因子：
2
通讯作者：
Long, Sam N.
中科院分区：
文献类型：
--
作者：
Hodge, Priscilla J.;Kelers, Kylie;Long, Sam N.
本文报告一例肉芽肿性阿米巴脑膜脑炎，患者为健康、成熟、有明显免疫功能、有积水暴露史的犬。该病例表现为共济失调，并有向左侧倾斜的倾向。计算机断层扫描(CT)显示小脑内环强化病变；脑脊液(CSF)检查显示非特异性混合细胞增多症。尽管接受了抗生素和消炎治疗，但临床症状迅速进展，在4天内消除了小脑僵硬，狗被安乐死。重要的尸检发现仅限于大脑，在小脑深层白质有局部溶解病变。脑组织病理学检查显示局灶性广泛的白质空洞，病变与第四脑室相通。感染区域含有与阿米巴一致的结构，并被中性粒细胞和较少数量的巨噬细胞、浆细胞和淋巴细胞渗透。根据特异性免疫荧光检测，该阿米巴被鉴定为曼陀罗巴拉穆斯虫。阿米巴脑膜脑炎应考虑用于有脑内局限性空洞病变证据的狗，特别是有在死水中游泳的病例。
A case of granulomatous amoebic meningoencephalitis in a previously healthy, mature, apparently immunocompetent dog, with a history of exposure to stagnant water, is reported. The case presented with ataxia and a tendency to fall to the left side. A computed tomography (CT) showed a ring-enhancing lesion within the cerebellum; an examination of cerebrospinal fluid (CSF) revealed nonspecific mixed-cell pleocytosis. Despite antibiotic and anti-inflammatory therapy, clinical signs progressed rapidly to decerebellate rigidity over 4 days, and the dog was euthanased. Significant post-mortem findings were restricted to the brain, with a localised lytic lesion in the deep cerebellar white matter. Histopathological examination of the brain showed focally extensive cavitation of the white matter and communication of the lesion with the fourth ventricle. The affected area contained structures consistent with amoebae and was infiltrated by neutrophils mixed with lower numbers of macrophages, plasma cells and lymphocytes. The amoebae were identified as Balamuthia mandrillaris, based on specific immunofluorescence detection. Amoebic meningeoencephalitis should be considered in dogs with evidence of focal cavitary lesions in the brain, particularly in cases with a history of swimming in stagnant water.