Balamuthia


Balamuthia

Description, Causes and Risk Factors:

Balamuthia

A genus of free-living ameba that causes granulomatous amebic encephalitis.

Balamuthia infection is very rare. The Balamuthia amebas can infect the skin, sinuses, brain and other organs of the body. Therefore, Balamuthia infection can cause a wide range of symptoms. Disease can begin with a skin wound on the face, trunk, or limbs and can then progress to the brain where it cause a disease called granulomatous amebic encephalitis (GAE).

Balamuthia can also cause a widespread infection involving multiple body parts. The disease might appear mild at first but can become more severe over weeks to several months. Often the disease is fatal, with a death rate of more than 95%. Overall, the outlook for people who get this disease is poor, although early diagnosis and treatment may increase the chances for survival.

Balamuthia mandrillaris is an emerging opportunistic protozoan pathogen, a member of the group of free-living amoebae. This infection is known to cause serious cutaneous infections and fatal encephalitis involving the central nervous system (CNS), with a case fatality rate of >98% (total estimated number of cases, 120). Despite such poor prognosis, the pathogenesis and pathophysiology associated with Balamuthia amoebic encephalitis (BAE) remain incompletely understood.

This ameba is responsible for sporadic meningoencephalitis, with mortality rates near 100%. About 200 cases have been reported Worldwide. Balamuthia ameba spread hematogeneously from a cutaneous, ocular, or pulmonary lesion to the CNS, where vasculitis dominates the clinical picture. Many patients are immunocompromised, but some are immunocompetent.

Symptoms:

    Headaches.

  • Stiff neck or head and neck pain with neck movement.

  • Sensitivity to light.

  • Nausea.

  • Vomiting.

  • Lethargy (tiredness).

  • Low-grade fever.

Other signs of balamuthia-induced granulomatous amoebic encephalitis include:

    Behavioral changes.

  • Seizures.

  • Weight loss.

  • Partial paralysis.

  • Speech difficulties.

  • Difficulty walking.

Diagnosis:

Balamuthia-induced granulomatous amebic encephalitis (GAE) is a serious infection of the brain and spinal cord caused by balamuthia. GAE is often diagnosed only after death. However, it can be diagnosed by examining blood, cerebrospinal fluid, and tissue samples from a living patient as well. Diagnosis of GAE in a living patient is less common because the amebas are difficult to identify under the microscope, even with commonly used stains.

However, there are three types of tests that can help confirm the diagnosis of GAE. The indirect immunofluorescence assay (IFA) is a test used to detect antibodies attached to Balamuthia amebas in body tissues. In contrast, immunohistochemistry (IHC) uses specific antibodies against this to detect the amebas. Finally, a polymerase chain reaction (PCR) molecular assay can detect Balamuthia DNA.

Treatment:

Current methods of treatment include a combination approach, where a mixture of drugs is administered, and even then the outcome remains extremely poor. There is an urgent need for improved antimicrobial chemotherapy and/or alternative strategies to develop therapeutic interventions. There is also a tremendous need for education (recognition of possible cases earlier in the infection, as well as prevention possibilities).

NOTE: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.

DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.

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