Acanthamoeba Infection in a Drowning Child

Abstract

BACKGROUND: Acanthamoeba infection is a potential life-threatening complication of drowning. Themanagement of drowning-associated Acanthamoeba infection remains controversial. Survival reports onAcanthamoeba infection have been on case reports only.CASE DETAILS: A 2-year-old, previously healthy Indonesian boy presented with decreasedconsciousness and inadequate breathing, followingdrowning. The event was unsupervised with unknownestimated time of submersion. Resuscitation was commenced and mechanical ventilated was applied.Sputum specimen revealed alive Acanthamoeba with pseudopods and cysts. Sputum culture resulted inPseudomonas aeruginosa and cerebrospinal fluid was supportive for Acanthamoeba with 1-3trophozoites and cyst. Imaging of the head showed cerebral edema and encephalitis. The patient receivedintravenous ceftazidime, metronidazole, fluconazole and rifampicin. The patient’s consciousness wasunsatisfactory regained resulting in an altered mental status.CONCLUSION: No treatment so far has given a succesful outcome for Acanthamoeba. In this case,management with metronidazole, rifampicin and fluconazole showed regain of consciousness resultingin altered mental status.