ACANTHAMOEBA.

Description

Acanthamoeba is derived from a Greek word Akantha which means spike or thorn.
They are microscopic unicellular organisms that are eukaryotic in nature. They can be easily
identified by the presence of spiny surface projections called acanthapodia on trophozoites.
Usually 25-40um in size.

Its incubation period is not known but can vary depending on the temperature and availability of
nutrients.

It is described as amphizoic organisms since it is both free living and parasitic.

First described by Castellani who reported the presence of amoeba in the fungus Cryptococcus
pararoseus culture, later on Volkonsky established its acanthamoeba in the year 1931.

History

In 1930, Castellani reported presence of an amoeba in fungus Cryptococcus pararoseus cultures.

Douglas placed this amoeba in genus Hartmonella and named it Hartmonella castellani.
In 1931 Volkonsky considered the genus Hartmanella to be an artificial combination of
unrelated amoebas thus subdividing it into 3 genera; amoebas
characterized by round, smooth walled cyst and cylindrical to truncated spindle in the genus
Hartmanella

Amoebas characterized by nuclear division in the cyst placed in the genus Glaeseria

Amoebas characterized by pointed spindles at mitosis and that have double walled cyst with
ostioles and irregular outer layer placed in genus Acanthamoeba.

Identified in 1958 during polio vaccines safety trials. Plagues appeared in cell cultures used to
prepare vaccines, thought to be virus included because mice and monkeys died of encephalitis
following inoculation of tissue culture fluid both trophozoite and cyst were detected in cell
structures. First case reported in 1970s.

First case of an HIV positive patient contracting Acanthamoeba was reported in 1986.

Modes of transmission

No insect vector

No human carrier state

Inhalation - nasal passage

Skin lesions

Infected contact lens

They then find their way into the lungs from where they reach the bloodstream and other parts
especially the central nervous system (brain and spinal cord)

Where found in the physical environment

Air

Soil

Water environment- fresh water, tap water, sewage.

Life cycle.

It undergoes two stages:

The cyst (inactive form) and trophozoite (active form)

The trophozoite is actively dividing through binary fission, mainly feeds on bacteria algae and
yeast. Uptake of food is by pseudopod formation and phagocytosis/ food cup formation.

Locomotion; formation of hyaline pseudopodium and is sluggish in all species of acanthamoeba.

ACANTHAMOEBA ASSOCIATED INFECTIONS.

Granulomatous amebic encephalitis.

It is described as a slow progressive CNS infection, may include the lungs.

Direct microscopy of wet mounts of (CSF) cerebrospinal fluid or stained smears of CSF
sediment. Should be centrifuged at low speeds to avoid rupture of trophozoites.
Generally associated with patients who have underlying disorders such as diabetes, renal failure,
Tb, cirrhosis

Amebic keratitis
it is a corneal infection that are common among the contact lens wearers.

Often mistaken for a typical herpes simplex keratitis or at times fungal keratitis.
Early treatment is essential because amebic cysts are resistant to many drugs.
If diagnosis and treatment not done early enough, may lead to permanent vision loss.

Diagnostics include scraping of the growth of amoeba and observing it by confocal microscopy.

Prevention: lens is dipped in 3% hydrogen peroxide (H2O2) to disinfect the lens against cysts
and trophozoites
Microwave irradiation effectively kills Acanthamoeba after 3mins of treatment.
Cutaneous Acanthamoebiasis

It’s an infection characterized by skin lesions and inflammation of the skin.

Mostly common among HIV positive patients. Can also be associated with non-HIV infected
persons with amebic encephalitis, patients undergoing immunosuppressive therapy after organ
transplant and those with immunological disorders.