• The Korean Journal of Cytopathology
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• v.4 no.2
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• pp.176-180
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• 1993

Clonorchiasis is common in Korea. The coinfection of amebic abscess with clonorchiasis is not rare in endemic areas. The coinfection may influence on its manifestations each other. We experienced a human case with unusal manifestation of amebic liver abscess associated with coinfection by Clonorchisis sinensis. The case was an 80-year-old female. She lived in Yongil-gun, Kyongsangbuk-do, Korea, She had multiple amebic abscess cavities in the liver, one of which subsided spontaneously and others newly appeared. She was diagnosed by CT guided aspiration of the cyst, which revealed trophozoites of ameba and eggs of C. sinensis. She was treated with praziquantel and metronidazale and was cured.

• Parasites, Hosts and Diseases
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• v.51 no.3
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• pp.335-341
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• 2013

Balamuthia mandrillaris is one of the 4 amebas in fresh water and soil that cause diseases in humans. Granulomatous amebic encephalitis (GAE), caused by B. mandrillaris, is a rare but life-threatening condition. A 4-year-old, previously healthy, Thai girl presented with progressive headache and ataxia for over a month. Neuroimaging studies showed an infiltrative mass at the right cerebellar hemisphere mimicking a malignant cerebellar tumor. The pathological finding after total mass removal revealed severe necrotizing inflammation, with presence of scattered amebic trophozoites. Cerebrospinal fluid (CSF) obtained from lumbar puncture showed evidence of non-specific inflammation without identifiable organisms. A combination of pentamidine, sulfasalazine, fluconazole, and clarithromycin had been initiated promptly before PCR confirmed the diagnosis of Balamuthia amebic encephalitis (BAE). The patient showed initial improvement after the surgery and combined medical treatment, but gradually deteriorated and died of multiple organ failure within 46 days upon admission despite early diagnosis and treatment. In addition to the case, 10 survivors of BAE reported in the PubMed database were briefly reviewed in an attempt to identify the possible factors leading to survival of the patients diagnosed with this rare disease.

• Parasites, Hosts and Diseases
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• v.61 no.2
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• pp.183-193
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• 2023

Balamuthia mandrillaris amebic encephalitis (BAE) can cause a fatal condition if diagnosis is delayed or effective treatment is lacking. Patients with BAE have been previously reported in 12 provinces of China, with skin lesions being the primary symptom and encephalitis developing after several years. However, a significantly lower number of cases has been reported in Southwest China. Here we report an aggressive BAE case of a 64-year-old woman farmer with a history of skin lesions on her left hand. She was admitted to our hospital due to symptoms of dizziness, headache, cough, vomiting, and gait instability. She was initially diagnosed with syphilitic meningoencephalitis and received a variety of empirical treatment that failed to improve her symptoms. Finally, she was diagnosed with BAE combined with amebic pneumonia using next-generation sequencing (NGS), qRT-PCR, sequence analysis, and imaging studies. She died approximately 3 weeks after the onset. This case highlights that the rapid development of encephalitis can be a prominent clinical manifestation of Balamuthia mandrillaris infection.

• Parasites, Hosts and Diseases
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• v.44 no.4 s.140
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• pp.321-330
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• 2006

The pathogenic mechanism of granulomatous amebic encephalitis (GAE) and amebic keratitis (AK) by Acanthamoeba has yet to be clarified. Pretense has been recognized to play an important role in the pathogenesis of GAE and AK. In the present study, we have compared specific activity and cytopathic effects (CPE) of purified 33 kDa serine proteinases from Acanthamoeba strains with different degree of virulence (A. healyi OC-3A, A. lugdunensis KA/E2, and A. castelianii Neff). Trophozoites of the 3 strains revealed different degrees of CPE on human corneal epithelial (HCE) cells. The effect was remarkably reduced by adding phenylmethylsulfonylfluoride (PMSF), a serine proteinase inhibitor. This result indicated that PMSF-susceptible proteinase is the main component causing cytopathy to HCE cells by Acanthamoeba. The purified 33 kDa serine proteinase showed strong activity toward HCE cells and extracellular matrix proteins. The purified proteinase from OC-3A, the most virulent strain, demonstrated the highest enzyme activity compared to KA/E2, an ocular isolate, and Neff, a soil isolate. Polyclonal antibodies against the purified 33 kDa serine proteinase inhibit almost completely the proteolytic activity of culture supernatant of Acanthamoeba. In line with these results, the 33 kDa serine proteinase is suggested to play an important role in pathogenesis and to be the main component of virulence factor of Acanthamoeba.

• Journal of Yeungnam Medical Science
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• v.34 no.1
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• pp.96-100
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• 2017

Amebic liver abscess (ALA) is the most common extraintestinal manifestation of amebiasis. Amebiasis, a parasitic infection caused by Entamoeba histolytica, used to be a prevalent protozoan disease in Korea, however, with an improving sanitary system, it has been among very uncommon etiology of liver abscess. A recent report suggested that ALA is an emerging parasitic infection in human immunodeficiency virus (HIV)-infected patients even in areas where the disease is not endemic and recommended HIV screening in patients in areas where ALA is not endemic, particularly those without history of travel to a disease-endemic area. We report on two patients who were admitted for treatment of ALA and then diagnosed as HIV infection. We also reviewed the etiology and characteristics of ALA in our hospital during the last 5 years.

• The Korean Journal of Nuclear Medicine
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• v.2 no.1
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• pp.53-58
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• 1968

Both primary hepatoma and amebic liver abscess are probably the most common space-occupying disease of the liver in Korea, and the importance of their accurate distinction can not be overemphasized. Radiogold hepatoscanning has been widely used at St. Mary's Hospital, and recently blood disappearance rate of colloidal $^{198}Au$ has been introduced in the study of hepatic ailments. A review of the literature revealed few previous publications concerning the differential features of the two conditions although some characteristic scan findings of each condition have been described. The present study is aimed at a critical review and analysis of various photoscan findings and blood disappearance rate determinations of colloidal $^{198}Au$ of 34 cases of primary hepatoma and 30 cases of amebic liver abscess. Among many scan manifestations, prominence of the uninvolved liver tissue, "hemispherical cold area," and splenic uptake are much more commonly encountered in primary hepatoma and the blood disappearance rate tends to be far more frequently delayed in primary hepatoma than in abscess providing at least a statistically useful basis of distinction of the two diseases.

• Parasites, Hosts and Diseases
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• v.57 no.3
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• pp.291-294
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• 2019

Primary amebic encephalitis (PAM) is a devastating central nervous system infection caused by Naegleria fowleri, a free-living amoeba, which can survive in soil and warm fresh water. Here, a 43-year-old healthy male was exposed to warm freshwater 5 days before the symptom onset. He rapidly developed severe cerebral edema before the diagnosis of PAM and was treated with intravenous conventional amphotericin B while died of terminal cerebral hernia finally. Comparing the patients with PAM who has similar clinical symptoms to those with other common types of meningoencephalitis, this infection is probably curable if treated early and aggressively. PAM should be considered in the differential diagnosis of purulent meningoencephalitis, especially in patients with recent freshwater-related activities during the hot season.

• Journal of Yeungnam Medical Science
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• v.25 no.1
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• pp.72-77
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• 2008

Liver abscess in children is rare in developed countries; the incidence is 25 per 100,000 admissions in USA. Common complications are pleural effusion, empyema, pneumonitis, hepatopleural or hepatobronchial fistula, intraperitoneal or intrapericardiac rupture, septic shock, cerebral amebiasis, etc. These complications may lead to death if the management is delayed. However, recent management results in a mortality of less than 15%. We report a case of liver abscess in a child. He manifested with fever and abdominal pain in the right upper quadrant. On computerized tomography scans, multiple cystic lesions were seen in both lobes of the liver and were 5 to 55 mm in size. In laboratory findings, neutrophilic leukocytosis, peripheral eosinophila, elevated values of ESR, C-reactive protein, and elevated serum AST, ALT, ALP and GGT were detected. Furthermore, we determined the organisms in the blood culture and serum. Blood culture was positive for Streptococcus spp., and amebic indirect hemagglutination antibody titer was increased to 1:512.

• 대한핵의학회:학술대회논문집
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• 1973.11a
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• pp.55.2-56
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• 1973

• Parasites, Hosts and Diseases
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• v.46 no.1
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• pp.37-40
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• 2008

Iron is an essential element for almost all living organisms. The possible role of iron for growth, adherence and cytotoxicity of Entamoeba histolytica was evaluated in this study. The absence of iron from TYI-S-33 medium stopped amebic growth in vitro. However, iron concentrations in the culture media of 21.4-285.6 ${\mu}M$ did not affect the growth of the amebae. Although growth was not retarded at these concentrations, the adhesive abilities of E. histolytica and their cytotoxicities to CHO cell monolayer were correlated with iron concentration. Amebic adhesion to CHO cell monolayers was significantly reduced by low-iron ($24.6{\pm}2.1%$) compared with $62.7{\pm}2.8\;and\;63.1{\pm}1.4%$ of amebae grown in a normal-iron and high-iron media, respectively. E. histolytica cultured in the normal- and high-iron media destroyed $69.1{\pm}4.3%\;and\;72.6{\pm}5.7%$ of cultured CHO cell monolayers, but amebae grown in the low-iron medium showed a significantly reduced level of cytotoxicity to CHO cells ($2.8{\pm}0.2%$). Addition of divalent cations other than iron to amebic trophozoites grown in the low-iron medium failed to restore levels of the cytotoxicity. However, when E. histolytica grown in low-iron medium were transferred to normal-iron medium, the amebae showed completely restored cytotoxicity within 7 days. The result suggests that iron is an important factor in the adherence and cytotoxicity of E. histolytica to CHO cell monolayer.