Microbiology
An amoeba from fresh water. Includes A. astronyxis, A. castellani, A. culbertsoni, A. hatchetti, A. palestinensis, A. polyphaga, A. rhysodes. A cousin of Naeglaria.
Epidemiologic Risks
Swimming in freshwater lakes, it goes up the first cranial nerve and into the brain. Also found in the environment. Ritual nasal rinsing a risk (PubMed), not unlike the use of Neti Pots (PubMed)(PubMed). Here is a suggestion: only squirt sterile water up your nose.
Syndromes
Primary meningitis, granulomatous meningitis in immunocompetent, keratitis (especially associated with contact lenses (PubMed)) and disseminated cutaneous acanthamebiasis in AIDS and other immunocompetent patients.
Treatment
Meningitis- Magical thinking includes (PubMed) combining pentamidine PLUS miconazole PLUS TMP/Sulfa PLUS amphotericin B. No matter what you do, the meningitis will prove fatal, or worse, they will survive with permanent brain damage. Similar therapy for disseminated and cutaneous disease. One case was treated with Miltefosine (PubMed). I will leave the treatment of keratitis to ophthalmology.
Notes
Last update: 05/05/18