Balamuthia mandrillaris is one of the 4 amebas in fresh water and soil that cause diseases in humans. Granulomatous amebic encephalitis (GAE), caused by B. mandrillaris, is a rare but life-threatening condition. A 4-year-old, previously healthy, Thai girl presented with progressive headache and ataxia for over a month. Neuroimaging studies showed an infiltrative mass at the right cerebellar hemisphere mimicking a malignant cerebellar tumor. The pathological finding after total mass removal revealed severe necrotizing inflammation, with presence of scattered amebic trophozoites. Cerebrospinal fluid (CSF) obtained from lumbar puncture showed evidence of non-specific inflammation without identifiable organisms. A combination of pentamidine, sulfasalazine, fluconazole, and clarithromycin had been initiated promptly before PCR confirmed the diagnosis of Balamuthia amebic encephalitis (BAE). The patient showed initial improvement after the surgery and combined medical treatment, but gradually deteriorated and died of multiple organ failure within 46 days upon admission despite early diagnosis and treatment. In addition to the case, 10 survivors of BAE reported in the PubMed database were briefly reviewed in an attempt to identify the possible factors leading to survival of the patients diagnosed with this rare disease.
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The role of plasma metagenomic sequencing in identification of Balamuthia mandrillaris encephalitis Sarah Y. Edminster, Ryan W. Rebbe, Christopher Khatchadourian, Kyle M. Hurth, Anna J. Mathew, Julie Huss-Bawab, Mark S. Shiroishi, Devin Clark, Andrew P. Norgan, Susan M. Butler-Wu, Annie Hiniker Acta Neuropathologica Communications.2025;[Epub] CrossRef
A Novel Balamuthia Lineage Causing Fatal Granulomatous Amoebic Encephalitis in an Immunocompetent Infant Zhongqiu Teng, Linlin Liu, Tianming Chen, Junrong Liang, Xingfeng Yao, Na Zhao, Fengmao Zhao, Hailang Sun, Lijuan Wang, Quan Wang, Gang Liu, Tian Qin International Journal of Infectious Diseases.2025; 161: 108063. CrossRef
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