Fatal granulomatous amoebic encephalitis caused by Balamuthia mandrillaris.
Granulomatous amoebic encephalitis caused by Balamuthia mandrillaris is rare (63 human) cases reported worldwide) and fatal. We report a case in a five-year-old boy who had previously been well. For 18 months, he had had a slowly progressive, granulomatous mid facial lesion, but despite extensive investigation definitive diagnosis was made only with the acute onset of neurological signs in the last two weeks of life, when a brain biopsy specimen revealed amoebic trophozoites and cysts. Infection with B. mandrillaris should be considered in the differential diagnosis of chronic skin lesions with non-specific granulomatous histopathology and negative microbiological test results.
Reed
R P
RP
Microbiology Department, Royal Melbourne Hospital, VIC. vgs@mis.medrmh.unimelb.edu.au
Cooke-Yarborough
C M
CM
Jaquiery
A L
AL
Grimwood
K
K
Kemp
A S
AS
Su
J C
JC
Forsyth
J R
JR
D000293:Adolescent; D000328:Adult; D000368:Aged; D000562:Amebiasis / Q000175:diagnosis / Q000469:parasitology*; D000818:Animals; D001921:Brain / Q000469:parasitology; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D004660:Encephalitis / Q000175:diagnosis / Q000469:parasitology*; D017809:Fatal Outcome; D005455:Fluorescent Antibody Technique; D006099:Granuloma / Q000469:parasitology*; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D012867:Skin / Q000469:parasitology; D012876:Skin Diseases, Parasitic / Q000469:parasitology*