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Fatal granulomatous amoebic encephalitis caused by Balamuthia mandrillaris
R P Reed1, C M Cooke-Yarborough, A L Jaquiery
1Microbiology Department, Royal Melbourne Hospital, VIC. vgs@mis.medrmh.unimelb.edu.au
The Medical Journal of Australia
|July 21, 1997
Summary
Granulomatous amoebic encephalitis caused by Balamuthia mandrillaris is a rare and fatal condition. Early consideration of B. mandrillaris is crucial for diagnosing chronic skin lesions with non-specific granulomatous findings.
Area of Science:
- Neurology
- Infectious Diseases
- Dermatology
Background:
- Granulomatous amoebic encephalitis (GAE) is a rare, fatal infection caused by Balamuthia mandrillaris.
- Only 63 human cases have been reported globally, highlighting its rarity.
Observation:
- A previously healthy five-year-old boy presented with an 18-month history of a slowly progressive, granulomatous mid-facial lesion.
- Neurological signs developed acutely in the final two weeks of life, prompting further investigation.
Findings:
- A brain biopsy confirmed the diagnosis, revealing amoebic trophozoites and cysts of Balamuthia mandrillaris.
- Extensive prior investigations had failed to establish a definitive diagnosis.
Implications:
- Balamuthia mandrillaris infection should be included in the differential diagnosis for chronic skin lesions with non-specific granulomatous histopathology.
- Negative microbiological test results should not exclude consideration of GAE in endemic or suspicious cases.
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