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Granulomatous amebic encephalitis is a multifocal, hemorrhagic and necrotizingencephalitis caused by opportunistic free-living Acanthamoebaspecies, principally A castellanii and Aculbertsoni or by B mandrillaris. The diseaseusually afflicts debilitated or immunosuppressed individuals. It sets in withinsidious, focal neurologic changes that mimic the clinical picture of single ormultiple space-occupying brain lesions (Table81-2). Focal neurologic changes, hemiparesis, drowsiness, personalitychanges, and seizures are common early symptoms. Headache sets in early and isinsidious. Nausea and vomiting may also be early symptoms. Fever is sporadic andgenerally low. Signs and symptoms of brain parenchymal inflammation develop,such as altered mental status, diplopia, paresis, lethargy, and cerebellarataxia. The disease progresses over a period of one to several weeks and usuallyends in coma and death.

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Unfortunately, in the United States, the U.S. Digital Millennium Copyright Act applies. This law not only forbids U.S. residents full and free access to their electronic purchases, it also forbids U.S. publishers like TidBITS from describing workarounds. Thus, I may not discuss here my own legal attempts to remove DRM. I may state, however, that, whether or not I have easily found DRM-removal tools for most ebooks, I have found no way to remove the DRM from ebooks purchased through Apple.

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