Disseminated Acanthamoeba Infection With Necrotic Skin Lesions And Granulomatous Vasculitis

09 Apr 20264 min read0 views

GIST (Key Takeaways)

Disclaimer: Early release articles are not considered as final versions. Any changes will be reflected in the online version in the month the article is officially released. An elderly man, on dupilumab therapy for asthma and sinus polyposis, sought care for necrotic skin lesions.
Biopsy revealed granulomatous vasculitis and he received immunosuppressive therapy but worsened. We diagnosed an Acanthamoeba infection that was treated with multidrug therapy including nitroxoline. Clinicians should be aware of this rare etiology for infectious vasculitis.
Acanthamoeba spp. are free-living amoeba (FLA) that can be pathogenic in humans. Acanthamoeba amebae are most known for causing contact lens-related keratitis.
Nonkeratitis invasive disease is primarily an opportunistic infection, and often fatal ( 1 , 2 ). The number of persons at risk for opportunistic infections is increasing and is compounded by a growing number of drugs with unique targets on the inflammatory cascade ( 3 ). Dupilumab is a fully human monoclonal antibody that inhibits interleukin-4 and interleukin-13 cytokines and the T2 inflammatory response ( 4 ).