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Related Experiment Video

Updated: Jan 24, 2026

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Amoebic Encephalitis Caused by Balamuthia mandrillaris.

Su Jung Kum1, Hye Won Lee1, Hye Ra Jung1

  • 1Department of Pathology, Keimyung University School of Medicine, Daegu, Korea.

Journal of Pathology and Translational Medicine
|May 25, 2019
PubMed
Summary

This case report details a fatal Balamuthia mandrillaris amoebic encephalitis in an immunosuppressed patient. Early diagnosis of this rare brain infection is challenging, often leading to rapid deterioration.

Keywords:
Amoebic encephalitisBalamuthia mandrillarisHistopathologic features

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Area of Science:

  • Neurology
  • Infectious Diseases
  • Parasitology

Background:

  • Balamuthia mandrillaris is a rare, free-living amoeba that can cause granulomatous amoebic encephalitis (GAE).
  • Immunosuppression, such as that from long-term corticosteroid use for rheumatoid arthritis, increases susceptibility to opportunistic infections.
  • GAE is often fatal, with diagnosis frequently delayed due to non-specific initial symptoms.

Purpose of the Study:

  • To report the first case of Balamuthia mandrillaris amoebic encephalitis with fatal progression in a Korean patient.
  • To highlight the diagnostic challenges and rapid clinical deterioration associated with this rare infection.
  • To emphasize the importance of considering amoebic encephalitis in immunocompromised individuals with neurological symptoms.

Main Methods:

  • Clinical case presentation of a 71-year-old male patient.
  • Review of patient's medical history, including rheumatoid arthritis and immunosuppressant therapy.
  • Magnetic resonance imaging (MRI) for initial neurological assessment.
  • Open brain biopsy for histopathological examination and identification of amoebic trophozoites and cysts.

Main Results:

  • Patient presented with neurological symptoms initially suggestive of brain metastases.
  • Histopathological analysis of brain biopsy revealed numerous amoebic trophozoites and cysts in hemorrhagic necrotic tissue.
  • Diagnosis of amoebic encephalitis caused by Balamuthia mandrillaris was confirmed.
  • The patient experienced rapid deterioration and died within 10 days of hospital admission.

Conclusions:

  • Balamuthia mandrillaris amoebic encephalitis is a rare but devastating infection, particularly in immunosuppressed individuals.
  • Early and accurate diagnosis remains a significant clinical challenge.
  • This case underscores the critical need for heightened clinical suspicion and prompt diagnostic measures to improve outcomes for amoebic encephalitis.