An infection with an Acanthamoeba species may present as a cutaneous disease. The prognosis is poor if the cutaneous involvement is part of disseminated disease.
Patients at risk for cutaneous acanthamebiasis:
(1) advanced HIV disease
(2) organ transplant recipient
(3) immunodeficiency state
(4) following immunosuppressive therapy
Clinical findings:
(1) hard erythematous papulonodules which may drain purulent material
(2) nonhealing and indurated ulcerations
(3) involvement of other organs if part of disseminated disease (sinusitis, pneumonia, encephalitis
Diagnosis can be made on histologic examination of a skin biopsy, which may show vasculitis, trophozoites and cysts.
Mortality is high if associated with disseminated disease. It is approximately 100% if CNS involvement is present.
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