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Published on: September 20, 2018

Amebic meningoencephalitides and keratitis: challenges in diagnosis and treatment

Govinda S Visvesvara1

  • 1Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. gsv1@cdc.gov

Current Opinion in Infectious Diseases
|August 31, 2010
PubMed
Abstract

Insights

Rapid PCR tests improve early diagnosis of deadly amebic infections caused by Acanthamoeba, Balamuthia mandrillaris, and Naegleria fowleri. Novel drug delivery systems show promise for treating these challenging central nervous system diseases.

Area of Science:

  • Medical Microbiology
  • Infectious Diseases
  • Parasitology

Background:

  • Free-living amebae, including Acanthamoeba spp., Balamuthia mandrillaris, and Naegleria fowleri, cause severe and often fatal human diseases.
  • Acanthamoeba causes granulomatous amebic encephalitis, keratitis, and disseminated infections. Naegleria fowleri causes primary amebic meningoencephalitis, a rapidly progressing CNS infection.

Purpose of the Study:

  • To review recent advancements in the diagnosis and treatment of diseases caused by these three free-living amebae.
  • To highlight challenges in clinical management and explore potential therapeutic strategies.

Main Methods:

  • Review of recent literature on diagnostic techniques and therapeutic interventions.
  • Focus on novel diagnostic assays and drug delivery systems.

Main Results:

  • Development of multiplex real-time PCR for simultaneous detection of all three amebae, offering rapid diagnosis (4-5 hours).
  • Chitosan microsphere loading of rokitamycin demonstrates enhanced and prolonged in-vitro anti-Acanthamoeba activity.

Conclusions:

  • Diagnosis of these amebic infections remains challenging, with current antimicrobial therapy often empirical and associated with high fatality rates.
  • Further research is crucial for developing improved drug delivery systems capable of crossing the blood-brain barrier to effectively treat central nervous system infections.

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