Balamuthia amoebic encephalitis directly causing intracranial infection: A case report

Balamuthia amoebic encephalitis (BAE) is a rare and often fatal central nervous system (CNS) infection caused by Balamuthia mandrillaris, a free-living amoeba typically found in soil and water. This organism can invade the brain directly, bypassing other organs, making early diagnosis particularly c...

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Main Authors: Yuhan Liang, Yanhong Liu, Zelong Chen, Jiayi Sun, Xuemeng Zhang, Yulin Wang
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:Radiology Case Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S1930043325001360
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author Yuhan Liang
Yanhong Liu
Zelong Chen
Jiayi Sun
Xuemeng Zhang
Yulin Wang
author_facet Yuhan Liang
Yanhong Liu
Zelong Chen
Jiayi Sun
Xuemeng Zhang
Yulin Wang
author_sort Yuhan Liang
collection DOAJ
description Balamuthia amoebic encephalitis (BAE) is a rare and often fatal central nervous system (CNS) infection caused by Balamuthia mandrillaris, a free-living amoeba typically found in soil and water. This organism can invade the brain directly, bypassing other organs, making early diagnosis particularly challenging. Symptoms often do not appear as distinctive early warning signs, and many patients do not experience noticeable skin lesions or systemic symptoms before neurological manifestations emerge. Balamuthia can enter the body through various routes, including the respiratory tract, skin, or gastrointestinal tract, eventually crossing the blood-brain barrier and causing aggressive encephalitis. The early symptoms of BAE are nonspecific, and the disease has an extremely high mortality rate. This report presents a 35-year-old male patient who died from Balamuthia amoebic encephalitis. The patient had a history of prolonged exposure to underground mines and consumed raw beef a week before the onset of symptoms. The infection is believed to have entered through the respiratory tract or gastrointestinal route. Diagnosis was primarily based on pathological findings, and the patient did not receive effective treatment due to delayed diagnosis, ultimately passing away approximately 2 months after the onset of symptoms. This case emphasizes the rarity and fatal nature of BAE, particularly when neurological symptoms are the first sign of infection without preceding systemic or dermatological manifestations. The report highlights the importance of considering Balamuthia mandrillaris infection in patients presenting with unexplained encephalitis and brain abscess, especially with a potential history of exposure to amoeba-contaminated environments.
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spelling doaj-art-bcdd59a0eb654edcb10e5b8cf2ff24c02025-08-20T02:16:55ZengElsevierRadiology Case Reports1930-04332025-06-012062820282410.1016/j.radcr.2025.02.035Balamuthia amoebic encephalitis directly causing intracranial infection: A case reportYuhan Liang0Yanhong Liu1Zelong Chen2Jiayi Sun3Xuemeng Zhang4Yulin Wang5Department of Radiology, The First Medical Center, Chinese PLA General Hospital, Beijing ChinaDepartment of Radiology, The First Medical Center, Chinese PLA General Hospital, Beijing ChinaDepartment of Radiology, The First Medical Center, Chinese PLA General Hospital, Beijing ChinaDepartment of Radiology, The First Medical Center, Chinese PLA General Hospital, Beijing ChinaDepartment of Radiology, The First Medical Center, Chinese PLA General Hospital, Beijing ChinaCorresponding author.; Department of Radiology, The First Medical Center, Chinese PLA General Hospital, Beijing ChinaBalamuthia amoebic encephalitis (BAE) is a rare and often fatal central nervous system (CNS) infection caused by Balamuthia mandrillaris, a free-living amoeba typically found in soil and water. This organism can invade the brain directly, bypassing other organs, making early diagnosis particularly challenging. Symptoms often do not appear as distinctive early warning signs, and many patients do not experience noticeable skin lesions or systemic symptoms before neurological manifestations emerge. Balamuthia can enter the body through various routes, including the respiratory tract, skin, or gastrointestinal tract, eventually crossing the blood-brain barrier and causing aggressive encephalitis. The early symptoms of BAE are nonspecific, and the disease has an extremely high mortality rate. This report presents a 35-year-old male patient who died from Balamuthia amoebic encephalitis. The patient had a history of prolonged exposure to underground mines and consumed raw beef a week before the onset of symptoms. The infection is believed to have entered through the respiratory tract or gastrointestinal route. Diagnosis was primarily based on pathological findings, and the patient did not receive effective treatment due to delayed diagnosis, ultimately passing away approximately 2 months after the onset of symptoms. This case emphasizes the rarity and fatal nature of BAE, particularly when neurological symptoms are the first sign of infection without preceding systemic or dermatological manifestations. The report highlights the importance of considering Balamuthia mandrillaris infection in patients presenting with unexplained encephalitis and brain abscess, especially with a potential history of exposure to amoeba-contaminated environments.http://www.sciencedirect.com/science/article/pii/S1930043325001360Balamuthia mandrillarisGranulomatous amoebic encephalitisEncephalitis
spellingShingle Yuhan Liang
Yanhong Liu
Zelong Chen
Jiayi Sun
Xuemeng Zhang
Yulin Wang
Balamuthia amoebic encephalitis directly causing intracranial infection: A case report
Radiology Case Reports
Balamuthia mandrillaris
Granulomatous amoebic encephalitis
Encephalitis
title Balamuthia amoebic encephalitis directly causing intracranial infection: A case report
title_full Balamuthia amoebic encephalitis directly causing intracranial infection: A case report
title_fullStr Balamuthia amoebic encephalitis directly causing intracranial infection: A case report
title_full_unstemmed Balamuthia amoebic encephalitis directly causing intracranial infection: A case report
title_short Balamuthia amoebic encephalitis directly causing intracranial infection: A case report
title_sort balamuthia amoebic encephalitis directly causing intracranial infection a case report
topic Balamuthia mandrillaris
Granulomatous amoebic encephalitis
Encephalitis
url http://www.sciencedirect.com/science/article/pii/S1930043325001360
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