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Under the radar: balamuthia amebic encephalitis
Frederick L Schuster1, Shigeo Yagi, Shilpa Gavali
1California Department of Public Health, Richmond, CA 94804, USA.
Summary
Balamuthia mandrillaris causes amebic encephalitis, often missed in diagnosis. Early detection through specific testing and awareness of elevated IL-6 and IL-8 cytokines can improve patient survival.
Area of Science:
- Neurology
- Infectious Diseases
- Medical Diagnostics
Background:
- Balamuthia mandrillaris is a cause of granulomatous amebic encephalitis.
- Data from 1999-2008 from the California Encephalitis Project are presented.
- This project aimed to identify causes of encephalitis.
Purpose of the Study:
- To identify cases of Balamuthia encephalitis within the California Encephalitis Project.
- To characterize the clinical and laboratory findings of Balamuthia encephalitis.
- To raise awareness of this rare but fatal disease.
Main Methods:
- Diagnostic testing of patient specimens for Balamuthia species.
- Tests included immunofluorescent staining, antibody titers, and PCR for Balamuthia DNA.
- Cerebrospinal fluid (CSF) analysis for cytokine levels (IL-6, IL-8).
Main Results:
- Ten cases of Balamuthia encephalitis were identified over 9 years.
- Patients presented with neurological symptoms, abnormal neuroimaging, and CSF.
- Elevated IL-6 and IL-8 cytokines in CSF distinguished Balamuthia infections.
Conclusions:
- Balamuthia encephalitis is underdiagnosed due to lack of clinician familiarity.
- Increased awareness and specific diagnostic testing are crucial for earlier diagnosis.
- Prompt diagnosis and treatment may improve survival rates for Balamuthia encephalitis.
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