Presentation
The infection might start from a minor, slowly progressive, skin ulceration that can be present for weeks to months before neurologic changes occur. The clinical and histologic presentation is easily confused with many other diseases. [ncbi.nlm.nih.gov]
Entire Body System
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High Fever
Fourteen days before her death, she presented with high fever and lost consciousness and later developed neck stiffness and abducens palsy. Computed tomography scans of the brain demonstrated multiple low-density areas throughout the brain. [ncbi.nlm.nih.gov]
Respiratoric
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Nasal Ulcer
We present a case of 23-year-old man with acute meningoencephalitis, accompanied by inflammation of a nasal ulcer. He had been healthy until six months prior to admission to the hospital when he had a motorcycle accident. [ncbi.nlm.nih.gov]
Skin
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Subcutaneous Nodule
Biopsies/excisions of the thigh lesion, a subcutaneous nodule, and a brain lesion were performed. He failed to respond to broad spectrum antibiotics and antineoplastic agents, and died within 6 weeks of the initial MRI scan of the brain. [ncbi.nlm.nih.gov]
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Dermatitis
Abstract Soil and freshwater-dwelling amoebae may opportunistically infect the skin and evoke a granulomatous dermatitis that camouflages their underlying morphology. [ncbi.nlm.nih.gov]
Neurologic
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Somnolence
He was initially agitated and confused but progressed to somnolence over a period of 12 h. He had no cervical lymphadenopathy or nuchal rigidity. Cardiac, pulmonary, and abdominal examination results were unremarkable. [jcm.asm.org]
Workup
Consideration of Balamuthia infection early in the disease course is the most important element of a diagnostic workup. [jcm.asm.org]
MR
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Mass Lesion of the Brain
These patients underwent craniotomies for evaluation of mass lesions for possible brain tumors. Granulomatous chronic inflammatory reaction and amebic trophozoites were found in brain biopsies. [ncbi.nlm.nih.gov]
Microbiology
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Toxoplasma Gondii
We describe a patient with advanced HIV infection and Balamuthia mandrillaris and Acanthamoeba amebic encephalitis with Toxoplasma gondii coinfection. A multidisciplinary effort and state-of-the-art diagnostic techniques were required for diagnosis. [ncbi.nlm.nih.gov]
It did not react with DNA from closely related Acanthamoeba (3 species), nor with DNA from Toxoplasma gondii, Leishmania major, Pneumocystis murina, Mycobacterium bovis (BCG), human brain, various mouse organs, or from human and murine cell lines. [edoc.rki.de]
Treatment
Prolonged anti-amebic treatment resulted in resolution of the aneurysm without clinical evidence of subarachnoid hemorrhage. [ncbi.nlm.nih.gov]
Balamuthia infection has had successful treatments. In two cases, both were treated with a cocktail of antibiotics and antifungal drugs, although if any or all of these medications played a part in treatment is unclear. [en.wikipedia.org]
Prognosis
We have screened serum samples from hospitalized patients with encephalitis for antibodies against these 2 amoebae as a means of detecting a disease with few defining symptoms and a poor prognosis. [ncbi.nlm.nih.gov]
[…] filtering out human sequences from the dataset, 119 sequence fragments (out of 20,000,000 total) aligned with 96-99[percnt] similarity to the three known genes for Balamuthia mandrillaris - a widespread amoeba and rare cause of meningoencephalitis with poor prognosis [n.neurology.org]
Treatment/prognosis. Prognosis is poor, in part because the diagnosis is often not considered until late in the disease course. There is no clear standard therapy for infections with B. mandrillaris. [jcm.asm.org]
Although the prognosis of amebic encephalitis caused by B. mandrillaris is still ominous, it may not be invariably fatal. [academic.oup.com]
Etiology
Abstract Acanthamoeba spp. are frequently the etiological agents of a severe form of sight-threatening keratitis, called Acanthamoeba keratitis. [ncbi.nlm.nih.gov]
Epidemiology
Rapid, specific, sensitive, and reliable detection requiring little pathogen-specific expertise is an absolute prerequisite for a successful therapy and a welcome tool for both experimental and epidemiological research. [ncbi.nlm.nih.gov]
LASJERDI Epidemiology and Infection. 2016; : 1 7 Novel culture medium for the axenic growth of Balamuthia mandrillaris Luis Fernando Lares-Jiménez,Ricardo Alfredo Gámez-Gutiérrez,Fernando Lares-Villa Diagnostic Microbiology and Infectious Disease. 2015 [doi.org]
ISSN: 0950-2688 EISSN: 1469-4409 URL: /core/journals/epidemiology-and-infection [cambridge.org]
Pathogenic free-living amoebae: Epidemiology and clinical review. Pathol Biol (Paris) 2012;60:399-405. 4. Schuster FL, Visvesvara GS. Free-living amoebae as opportunistic and non-opportunistic pathogens of humans and animals. [ijmm.org]
Pathophysiology
Here, we present a brief overview of the current understanding of the morphology, biology, pathogenesis, and pathophysiology of B. mandrillaris encephalitis. [ncbi.nlm.nih.gov]
Prevention
Author information 1 Laboratory of Free-Living Amebae, Division of Foodborne, Waterborne and Environmental Diseases and Division of Scientific Resources, National Center for Environmental and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention [ncbi.nlm.nih.gov]