Of all the known ways to get an Acanthamoeba infection, nasal rinsing was the most likely one in the man’s case. The man had nasal polyps and used sinus rinses to alleviate his symptoms. However, his symptoms didn’t start in his nasal passages—they started on his legs. There, red nodules formed and progressed to develop dark centers. Some became deep ulcers, while others became necrotic, turning to black scabs. Then began erupting on his trunk, arms, and neck.
Catching a killer
Before his transfer to Yale, doctors elsewhere tried to identify the mysterious cause, doing multiple biopsies of his diseased skin. Tests were negative for bacterial or fungal pathogens.
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