{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T02:54:56Z","timestamp":1783392896598,"version":"3.54.6"},"reference-count":21,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,3,9]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n<jats:p><jats:italic>Acanthamoeba<\/jats:italic> brain abscess is very rare and most often fatal. There remains no standardized regimen for its management. We report a case in northern Australia of an immunosuppressed 57-year-old man who presented with diarrhea and weight loss, and was diagnosed with multiple <jats:italic>Acanthamoeba<\/jats:italic> brain abscesses after neurological deterioration. This case is the first successful treatment with surgical excision followed by combination antimicrobial therapy including miltefosine. This case was treated initially as nocardiosis or melioidosis, emphasizing the importance of considering differentials such as <jats:italic>Acanthamoeba<\/jats:italic> during workup of atypical infection. We present a literature review of the 14 <jats:italic>Acanthamoeba<\/jats:italic> brain abscess cases reported in the English literature, of which five were successfully treated. Our review shows a predilection for multiple brain abscesses and an increased mortality rate compared with the general brain abscess population.<\/jats:p>","DOI":"10.4269\/ajtmh.21-0166","type":"journal-article","created":{"date-parts":[[2022,1,20]],"date-time":"2022-01-20T08:35:45Z","timestamp":1642667745000},"page":"861-866","source":"Crossref","is-referenced-by-count":4,"title":["Case Report: First Successful Treatment of Acanthamoeba Brain Abscess with Combination Surgical Excision and Miltefosine-Led Antimicrobial Therapy"],"prefix":"10.4269","volume":"106","author":[{"given":"Anson","family":"Chan","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Townsville University Hospital, Douglas, Townsville, Queensland, Australia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Cairns Base Hospital, Cairns, Queensland, Australia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edwin","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Anatomical Pathology, Townsville University Hospital, Douglas, Townsville, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarin","family":"Kuruvath","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Townsville University Hospital, Douglas, Townsville, Queensland, Australia;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","series-title":"BMJ","first-page":"740","article-title":"Acute pyogenic meningitis probably due to Acanthamoeba sp.: a preliminary report","volume":"2","year":"1965"},{"key":"b2","series-title":"Neuropathology","first-page":"183","article-title":"Acanthamoeba meningoencephalitis in an immunocompetent patient: an autopsy case report","volume":"31","year":"2011"},{"key":"b3","series-title":"J Neurosurg","first-page":"505","article-title":"Granulomatous brain tumor caused by Acanthamoeba","volume":"64","year":"1986"},{"key":"b4","series-title":"Med J Aust","first-page":"47","article-title":"Isolation of Acanthamoeba from a cerebral abscess","volume":"148","year":"1988"},{"key":"b5","series-title":"J Clin Microbiol","first-page":"3892","article-title":"Granulomatous amebic encephalitis in a patient with AIDS: isolation of Acanthamoeba sp. group II from brain tissue and successful treatment with sulfadiazine and fluconazole","volume":"38","year":"2000"},{"key":"b6","series-title":"J Neurosurg","first-page":"572","article-title":"Cerebrospinal acanthamebic granulomas","volume":"99","year":"2003"},{"key":"b7","series-title":"Transpl Infect Dis","first-page":"191","article-title":"Acanthamoeba castellani encephalitis following partially mismatched related donor peripheral stem cell transplantation","volume":"5","year":"2003"},{"key":"b8","series-title":"J Clin Microbiol","first-page":"4265","article-title":"Fatal granulomatous Acanthamoeba encephalitis mimicking a stroke, diagnosed by correlation of results of sequential magnetic resonance imaging, biopsy, in\u00a0vitro culture, immunofluorescence analysis, and molecular analysis","volume":"44","year":"2006"},{"key":"b9","series-title":"Liver Transpl","first-page":"308","article-title":"Cure of Acanthamoeba cerebral abscess in a liver transplant patient","volume":"14","year":"2008"},{"key":"b10","series-title":"J Clin Microbiol","first-page":"446","article-title":"Granulomatous amebic encephalitis in a child with acute lymphoblastic leukemia successfully treated with multimodal antimicrobial therapy and hyperbaric oxygen","volume":"49","year":"2011"},{"key":"b11","series-title":"J Clin Microbiol","first-page":"1128","article-title":"Balamuthia mandrillaris and Acanthamoeba amebic encephalitis with neurotoxoplasmosis coinfection in a patient with advanced HIV infection","volume":"50","year":"2012"},{"key":"b12","series-title":"Surg Neurol Int","first-page":"68","article-title":"Acanthamoeba encephalitis: a case report and review of therapy","volume":"5","year":"2014"},{"key":"b13","series-title":"Neurol India","first-page":"101","article-title":"Fatal granulomatous amoebic encephalitis caused by Acanthamoeba in a newly diagnosed patient with systemic lupus erythematosus","volume":"64","year":"2016"},{"key":"b14","series-title":"Am J Trop Med Hyg","first-page":"307","article-title":"Acanthamoeba brain abscess confirmed by molecular identification","volume":"97","year":"2017"},{"key":"b15","series-title":"Indian J Hematol Blood Transfus","first-page":"153","article-title":"An unusual cause of central nervous system infection during acute myeloid leukemia induction chemotherapy: Acanthamoeba brain abscess","volume":"34","year":"2018"},{"key":"b16","series-title":"J Neurosurg","first-page":"794","article-title":"Brain abscess: a review of 400 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