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Conference Agenda

Overview and details of the sessions of this conference. Please select a date or location to show only sessions at that day or location. Please select a single session for detailed view (with abstracts and downloads if available).

Daily Overview

Session

CP17.2: Epidemiology & Diagnostics 5 min talks
Location: Lecture Theatre 3
Session Chair: Deepani Fernando, QIMR Berghofer
Session Chair: Luke Hall, St Vincent's Hospital Sydney

Presentation 2

Incidental finding of amoeba on nasal cavity of an immunocompetent patient. A case report and review of the literature.

Gautam Bhanot¹, Elizabeth Paver², Karina Kennedy³

1: Microbiology registrar, John Hunter Hospital; NSW Health Pathology.; 2: Anatomical pathologist, ACT Pathology, Canberra Health Services.; 3: Microbiologist and Infectious Diseases physician, ACT Pathology, Canberra Health Services

A 71-year-old man was found incidentally to have a crusted lesion on the floor of the nose during resection of a pituitary tumour. Microscopy showed an inflammatory infiltrate with ovoid cells, staining positive with PAS and silver raising concern for a free-living amoeba (FLA). However, multiplex PCR for Acanthamoeba species, Balamuthia mandrillaris and Naegleria fowleri was negative. There was no clinicoradiological evidence of meningoencephalitis. We reviewed the biology, clinical features and diagnosis of FLA infections.

Amongst 26 cases of rhinosinusitis, Acanthamoeba species were implicated in 25 and Entamoeba histolyticain one. The average age of patients was 43 mostly males. 11 patients died. Histopathology was used for diagnosis in 21 cases, PCR in 7. In two cases both were utilised. Culture was used in 1 case. All Acanthamoeba cases were associated with immunosuppression; HIV (17), CLL and solid organ transplant (3), haematopoietic stem cell transplant (1) and one hypogammaglobulinaemia.

Our asymptomatic case represents a dilemma, without literature to guide management in an incidental finding of amoeba in histopathological specimen especially after breach of the nasal mucosa for biopsy. FLA are ubiquitous and are found as carriers in the nose of volunteers. Disease likely affects immunosuppressed patients with compatible inoculation route.