Related Experiment Videos
Pediatric granulomatous cerebral amebiasis: a delayed diagnosis
Marcelo Galarza1, Vicente Cuccia, Fidel P Sosa
1Department of Neurosurgery, Hospital Nacional de Pediatría, Prof. Dr. J. P. Garrahan, Buenos Aires, Argentina.
Pediatric Neurology
|March 19, 2002
Summary
Granulomatous amebic encephalitis caused by Balamuthia mandrillaris is a rare but fatal infection. This study highlights four cases with neurological symptoms and skin lesions, emphasizing the need for early diagnosis.
Area of Science:
- Neurology
- Infectious Diseases
- Pathology
Background:
- Cerebral amebiasis is a rare and often fatal central nervous system infection.
- Balamuthia mandrillaris is an opportunistic amoeba that can cause granulomatous amebic encephalitis (GAE).
Observation:
- Four human immunodeficiency virus-negative patients presented with neurological deficits and skin lesions.
- Patients exhibited symptoms such as hemiparesis, partial seizures, and stroke-like episodes.
- Skin lesions preceded or coincided with neurological manifestations in three of the four cases.
Findings:
- Histopathology confirmed granulomatous amebic encephalitis in all patients.
- Balamuthia mandrillaris was identified as the causative agent in all cases.
- Standard treatment regimens including pentamidine, clarithromycin, fluconazole, and 5-fluorocytosine were ineffective.
Implications:
- GAE should be considered in the differential diagnosis of unexplained cerebral lesions, especially when accompanied by cutaneous manifestations.
- The identification of Balamuthia mandrillaris underscores the importance of specific diagnostic approaches for amoebic infections.
- The ineffectiveness of current treatments highlights the urgent need for novel therapeutic strategies against Balamuthia mandrillaris infections.