Fatal Balamuthia mandrillaris Encephalitis
Balamuthia mandrillaris is a rare cause of granulomatous meningoencephalitis associated with high mortality. We report a 69-year-old Caucasian female who presented with a 3-day history of worsening confusion and difficulty with speech. On admission, she was disoriented and had expressive dysphasia....
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| Format: | Article |
| Language: | English |
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Wiley
2019-01-01
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| Series: | Case Reports in Infectious Diseases |
| Online Access: | http://dx.doi.org/10.1155/2019/9315756 |
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| author | Binoy Yohannan Mark Feldman |
| author_facet | Binoy Yohannan Mark Feldman |
| author_sort | Binoy Yohannan |
| collection | DOAJ |
| description | Balamuthia mandrillaris is a rare cause of granulomatous meningoencephalitis associated with high mortality. We report a 69-year-old Caucasian female who presented with a 3-day history of worsening confusion and difficulty with speech. On admission, she was disoriented and had expressive dysphasia. Motor examination revealed a right arm pronator drift. Cerebellar examination showed slowing of finger-nose testing on the left. She was HIV-negative, but the absolute CD4 count was low. Neuroimaging showed three cavitary, peripherally enhancing brain lesions, involving the right frontal lobe, the left basal ganglia, and the left cerebellar hemisphere. She underwent right frontal craniotomy with removal of tan, creamy, partially liquefied necrotic material from the brain, consistent with granulomatous amoebic encephalitis on tissue staining. Immunohistochemical studies and PCR tests confirmed infection with Balamuthia mandrillaris. She was started on pentamidine, sulfadiazine, azithromycin, fluconazole, flucytosine, and miltefosine. The postoperative course was complicated by an ischemic stroke, and she died a few weeks later. |
| format | Article |
| id | doaj-art-ca303e45cb3b45cb9f1eeb98921553f2 |
| institution | Kabale University |
| issn | 2090-6625 2090-6633 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Infectious Diseases |
| spelling | doaj-art-ca303e45cb3b45cb9f1eeb98921553f22025-02-03T06:01:39ZengWileyCase Reports in Infectious Diseases2090-66252090-66332019-01-01201910.1155/2019/93157569315756Fatal Balamuthia mandrillaris EncephalitisBinoy Yohannan0Mark Feldman1Department of Internal Medicine, Texas Health Presbyterian Hospital Dallas, Dallas 75231, USADepartment of Internal Medicine, Texas Health Presbyterian Hospital Dallas, Dallas 75231, USABalamuthia mandrillaris is a rare cause of granulomatous meningoencephalitis associated with high mortality. We report a 69-year-old Caucasian female who presented with a 3-day history of worsening confusion and difficulty with speech. On admission, she was disoriented and had expressive dysphasia. Motor examination revealed a right arm pronator drift. Cerebellar examination showed slowing of finger-nose testing on the left. She was HIV-negative, but the absolute CD4 count was low. Neuroimaging showed three cavitary, peripherally enhancing brain lesions, involving the right frontal lobe, the left basal ganglia, and the left cerebellar hemisphere. She underwent right frontal craniotomy with removal of tan, creamy, partially liquefied necrotic material from the brain, consistent with granulomatous amoebic encephalitis on tissue staining. Immunohistochemical studies and PCR tests confirmed infection with Balamuthia mandrillaris. She was started on pentamidine, sulfadiazine, azithromycin, fluconazole, flucytosine, and miltefosine. The postoperative course was complicated by an ischemic stroke, and she died a few weeks later.http://dx.doi.org/10.1155/2019/9315756 |
| spellingShingle | Binoy Yohannan Mark Feldman Fatal Balamuthia mandrillaris Encephalitis Case Reports in Infectious Diseases |
| title | Fatal Balamuthia mandrillaris Encephalitis |
| title_full | Fatal Balamuthia mandrillaris Encephalitis |
| title_fullStr | Fatal Balamuthia mandrillaris Encephalitis |
| title_full_unstemmed | Fatal Balamuthia mandrillaris Encephalitis |
| title_short | Fatal Balamuthia mandrillaris Encephalitis |
| title_sort | fatal balamuthia mandrillaris encephalitis |
| url | http://dx.doi.org/10.1155/2019/9315756 |
| work_keys_str_mv | AT binoyyohannan fatalbalamuthiamandrillarisencephalitis AT markfeldman fatalbalamuthiamandrillarisencephalitis |