Recently, balamuthia meningoencephalitis, a usually fatal infection caused by the ubiquitous freeliving ameba balamuthia mandrillaris, has been reported worldwide in. Clinicians should consider balamuthia as a cause of encephalitis in transplant recipients, particularly in those recipients who received organs from a donor who died from a neurologic or unknown cause of death transplant centers and organ procurement. Health promotion materials balamuthia parasites cdc. Linking to a nonfederal website does not constitute an endorsement by cdc or any of its employees of the sponsors or the information and products presented on the website. These amoebae have gained medical importance in recent years since. Sep 08, 2015 the common soil amoeba balamuthia mandrillaris here shown devouring a plate of cultured human cells is usually harmless.
Balamuthia species infectious disease and antimicrobial. Balamuthia in particular is known to present with a range of inflammatory patterns. Shortly after, the recipients developed neurologic. Balamuthia madrillaris is a freeliving ameba found in soil worldwide that causes skin lesions and balamuthia granulomatous amebic encephalitis gae, a rare central nervous system infection that usually is fatal. Transmission of balamuthia mandrillaris through solid organ transplantation. Balamuthia infection is a cutaneous condition resulting from balamuthia that may result in various skin lesions 422 balamuthia mandrillarisis a freeliving amoeba a singlecelled living organism found in the environment. Balamuthia mandrillaris is an emerging cause of subacute granulomatous amebic encephalitis gae.
An ameba, balamuthia mandrillaris, within a culture of monkey kidney feeder cells. Publications for sequences of balamuthia in the dna. Diagnostic challenges in balamuthia mandrillaris infections. Demographic, clinical, and laboratory features of cases involving transmission of balamuthia infection from an organ donor to two kidney recipients mississippi, 20092010. Balamuthia mandrillaris transmitted through organ transplantation mississippi, 2009 first published. Transmission of freeliving ameba from the environment to hosts usually occurs via skin breakage or via the respiratory system. Alternate modes of infection reported in literature include organ transplantation. Transmission of balamuthia mandrillaris by organ transplantation. Emergence of balamuthia mandrillaris meningoencephalitis in india s khurana 1, v hallur 1, mk goyal 2, r sehgal 1, bd radotra 3 1 department of medical parasitology, postgraduate institute of medical education and research, chandigarh, india 2 department of neurology, postgraduate institute of medical education and research, chandigarh, india 3 department of histopathology, postgraduate. Pdf transmission of balamuthia mandrillaris by organ.
Balamuthia mandrillaris, previously called leptomyxid ameba, is the only species included under the genus balamuthia. Balamuthia mandrillaris is a pathogenic freeliving amoeba that causes a rare but almost always fatal infection of the central nervous system called granulomatous amoebic encephalitis gae. Transmission of balamuthia mandrillaris through solid. Pdf transmission of balamuthia mandrillaris through solid. Approximately 100 published and unpublished cases of balamuthia amebic encephalitis bae have been reported. Cutaneous balamuthia mandrillaris infection as a precursor. Balamuthia is thought to enter the body when soil containing balamuthia comes in contact with skin wounds and cuts, or when dust containing balamuthia is breathed in. Risk for transmission of naegleria fowleri from solid. Soil and freshwaterdwelling amoebae may opportunistically infect the skin and evoke a granulomatous dermatitis that camouflages their underlying morphology. Cysts are highly resistant to physical and chemical conditions and present a problem in successful antimicrobial chemotherapy. Research article diagnosing balamuthia mandrillaris encephalitis with metagenomic deep sequencing michael r. Diagnosis of granulomatous amebic encephalitis gae was made on autopsy.
The infection has been described more commonly in inmunocompetent individuals, mostly males, many children, and with a predilection for population with hispanic background in cases occurring in the. Balamuthia mandrillaris pdf icon pdf 1 page freeliving ameba testing at cdc. Transmission of balamuthia mandrillaris through solid organ. Background methods results conclusions cdcs freeliving ameba program acknowledgements and contact information magnetic resonance imaging mri of patient with balamuthia gae. Balamuthia mandrillaris infection was confirmed with. Granulomatous amoebic encephalitis gae is a rare, usually fatal, subacutetochronic central nervous system disease caused by certain species of freeliving amoebae of the genera acanthamoeba, balamuthia and sappinia pedata. Below are links to fact sheets on balamuthia related topics that can be displayed in public places or distributed to specific audience groups. Balamuthia can cause a rare and serious infection of the brain called granulomatous amebic encephalitis gae.
Updated july 2015 balamuthia mandrillaris was first identified in 1990, isolated from a pregnant mandrill papio sphinx that died of meningoencephalitis visvesvara et al. Information on submitting specimens to cdcs freeliving and intestinal amebas flia laboratory for testing. Balamuthia mandrillaris infection definition of balamuthia. Diagnosing balamuthia mandrillaris encephalitis with. Balamuthia mandrillaris chows down on a plate of cultured. Originally isolated from the brain of a mandrill that died of meningoencephalitis at the san diego zoo, balamuthia mandrillaris is named for the late professor william balamuth of the university of california. Balamuthia mandrillaris is a free living amoeba that can be isolated from soil. Balamuthia species infectious disease and antimicrobial agents. Balamuthia mandrillaris is a freeliving amoeba that is known to cause the deadly but rare neurological condition known as granulomatous amoebic encephalitis gae. Kidneys were transplanted from a donor with presumptive diagnosis of autoimmune encephalitis. An opportunistic amoeba that lives in soil and water. Balamuthia mandrillaris an overview sciencedirect topics. In more modern references, the term balamuthia amoebic encephalitis bae is commonly used when balamuthia.
Since its original identification, a number of cases of fatal encephalitis attributable to b. A 52yearold woman with idiopathic seizures and a 2year history of chronic. On average, a balamuthia trophozoite is approximately 30120 m across. Genotyping of balamuthia mandrillaris based on nuclear 18s and mitochondrial 16s rrna genes. Transmission remote allows you to remotely control transmission bittorrent client. Balamuthia mandrillaris is a freeliving amoeba that is known to cause the deadly neurological condition known as granulomatous amoebic encephalitis gae. Emergence of balamuthia mandrillaris meningoencephalitis. The radiographic findings of two patients with balamuthia infection one, a rare. The radiographic findings of two patients one, a rare survivor with meningoencephalitis caused by balamuthia mandrillaris are presented with pathologic correlation. Pdf transmission of balamuthia mandrillaris through. Transplant transmission of another fla, balamuthia mandrillaris, has been reported on three occasions 911, prompting questions about the potential risk for transplant transmission of n.
Further morphological observations of trophozoites by light, scanning and transmission electron microscopy author links open overlay panel arturo gonzalezrobles a fernando laresvilla c luis fernando laresjimenez c maritza omanamolina b lizbeth salazarvillatoro a adolfo martinezpalomo a. Balamuthia mandrillaris meningoencephalitis associated with. To our knowledge, imaging findings have not been reported. Pathogenic free living amebae naegleria fowleri acanthamoeba balamuthia mandrillaris 29. Balamuthia mandrillaris, a freeliving soil ameba, can cause granulomatous amebic encephalitis as well as nasopharyngeal, cutaneous, and disseminated infections in humans, nonhuman primates, and other animals. Aug 24, 2015 amoebic encephalitis can show various histological patterns, and in this case no granulomatous component was observed in the brain biopsy specimen. Diagnosing balamuthia mandrillaris encephalitis with metagenomic deep sequencing michael r. Its supposed routes of infection have been largely assumed from what is known about acanthamoeba spp. Cutaneous balamuthia mandrillaris infection as a precursor to. Freeliving amoebae are protozoa found worldwide in an extensive diversity of wet and soil environments. It can cause a potentially fatal infection of the brain and meninges, esp. Balamuthia mandrillaris 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. Nov 15, 2003 balamuthia mandrillaris is a freeliving amoeba that is found in soil and is responsible for. Balamuthia mandrillaris is a freeliving, heterotrophic amoeba, consisting of a standard complement of organelles surrounded by a threelayered cell wall, and with an abnormally large, vesicular nucleus.
The granulomas can affect the face as well as the brain, and those in the brain cause spaceoccupying symptoms and signs. It is a granulomatous encephalitis that can affect both humans and animals. Balamuthia mandrillaris, a soil amoeba, is the causative agent of balamuthia granulomatous amoebic encephalitis, a lifethreatening brain infection. Successful treatment of balamuthia amoebic encephalitis. Links with this icon indicate that you are leaving the cdc website the centers for disease control and prevention cdc cannot attest to the accuracy of a nonfederal website. Clin microbiol rev we are reporting the first cases of human to human transmission of b. Human cases can present with a skin lesion followed. We report a case of pathologically proven balamuthia encephalitis with unusual laboratory and radiologic findings. A major concern during the course of therapy is that b. Naegleria fowleri worldwide distribution motile at 21. Transmission of balamuthia mandrillaris by organ transplantation article pdf available in clinical infectious diseases 637. Education and information about balamuthia, including fact sheets and information on prevention and control, epidemiology, diagnosis and treatment. Utility of organ recipient serology to guide clinical management asmita a.
The diagnosis of this infection has proven to be difficult and is usually made postmortem. We report the first identified transmission of balamuthia mandrillaris through solid organ transplantation. Transmission of balamuthia infection has occurred via organ transplantation from infected donors on three documented occasions. This amoeba is acquired from contaminated soil and may enter the host through cutaneous lesions or through nasal passages, migrating to the lungs or brain. Parasites balamuthia mandrillaris granulomatous amebic. Balamuthia mandrillaris is a freeliving amoeba that is found in soil and is responsible for. Balamuthia mandrillaris, descrita por primera vez en 1986, es una ameba anfizoica. Balamuthia mandrillaris is a newly described pathogen that causes granulomatous amebic encephalitis, an extremely rare clinical entity that usually occurs in immunosuppressed individuals. Balamuthia extends from its branched pseudopodia while its ropelike body curves over and around a nucleus of a kidne. It is one of the causes of granulomatous amoebic encephalitis gae, a serious infection of the brain and spinal cord. The cysts fall approximately in this range as well. Publications for sequences of balamuthia in the dna databases. Balamuthia mandrillaris balamuthia, a freeliving ameba fla first identified in 1986 in a mandrill baboon that died of encephalitis, causes granulomatous amebic encephalitis gae in humans. Warum torrents eine bedrohung darstellen welivesecurity.
Balamuthia mandrillaris is a freeliving ameba a singlecelled living organism naturally found in the environment. Balamuthia mandrillaris amebic encephalitis springerlink. Balamuthia mandrillaris meningoencephalitis in an immunocompromised patient. Balamuthia mandrillaris wikipedia, a enciclopedia livre. A case of balamuthia mandrillaris meningoencephalitis. Balamuthia mandrillaris meningoencephalitis associated. Balamuthia amebic encephalitis risk, hispanicamericans.
Recently, balamuthia meningoencephalitis, a usually fatal infection caused by the ubiquitous freeliving ameba balamuthia mandrillaris, has been reported worldwide in both immunosuppressed and immunocompetent hosts 19. Balamuthia mandrillaris, an opportunistic agent of. The interaction between the amoeba balamuthia mandrillaris. Early recognition and treatment may offer some benefit. It is one of the causes of granulomatous amebic encephalitis gae, a serious infection of the brain and spinal cord 1,2,5,6. Based on molecular analysis, all isolates studied so far appear to be homogeneous and belong to one genotype. Balamuthia mandrillarisis a freeliving ameba a singlecelled living organism found in the environment. Jun 22, 2007 amebic encephalitis caused by balamuthia spp is an increasingly recognized chronic granulomatous central nervous system infectious process, which may affect both immunocompetent and immunocompromised individuals. Most cases have been diagnosed at postmortem examination and, as a consequence, nothing has been demonstrated to constitute effective therapy. Balamuthia mandrillaris, first isolated from the brain of a mandrill, and often referred to in the literature as a leptomyxid amoeba, also causes granulomatous amoebic encephalitis gae 2,3,5,6. Balamuthia mandrillaris infection a disease, first described in 1990, caused by the amoebic protozoal organism balamuthia mandrillaris. The course of the disease is insidious and fatal in most cases, mainly due to delayed diagnosis, difficulty in isolation andor identification of the organism, and lack of well.
Balamuthia mandrillaris acanthamoeba and freeliving amoebae. Balamuthia mandrillaris is an emerging opportunistic protozoan pathogen, a member of the group of freeliving amoebae. Jul 30, 2004 balamuthia mandrillaris is a freeliving ameba and an opportunistic agent of lethal granulomatous amebic encephalitis gae in humans and other mammals. Symptoms of gae personality and behavioral changes depressed mental status fever photophobia.
It is an emerging pathogen causing skin lesions as well as cns involvement with a fatal outcome if untreated. This report describes a previously healthy woman who died from gae due to b. Balamuthia mandrillaris is a causative agent of granulomatous encephalitis that almost always proves fatal. Free swimming flagellate pear shaped wit 2 flagella 3. It is found in soil and thought to occur worldwide 2, 3. The common soil amoeba balamuthia mandrillaris here shown devouring a plate of cultured human cells is usually harmless.
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