Post-mortem culture of Balamuthia mandrillaris from the brain and cerebrospinal fluid of a case of granulomatous amoebic meningoencephalitis, using human brain microvascular endothelial cells.
The first isolation in the UK of Balamuthia mandrillaris amoebae from a fatal case of granulomatous amoebic meningoencephalitis is reported. Using primary cultures of human brain microvascular endothelial cells (HBMECs), amoebae were isolated from the brain and cerebrospinal fluid (CSF). The cultures showed a cytopathic effect at 20-28 days, but morphologically identifiable B. mandrillaris amoebae were seen in cleared plaques in subcultures at 45 days. The identification of the organism was later confirmed using PCR on Chelex-treated extracts. Serum taken while the patient was still alive reacted strongly with slide antigen prepared from cultures of the post-mortem isolate, and also with those from a baboon B. mandrillaris strain at 1:10,000 in indirect immunofluorescence, but with Acanthamoeba castellanii (Neff) at 1:160, supporting B. mandrillaris to be the causative agent. If the presence of amoebae in the post-mortem CSF reflects the condition in life, PCR studies on CSF and on biopsies of cutaneous lesions may also be a valuable tool. The role of HBMECs in understanding the interactions of B. mandrillaris with the blood-brain barrier is discussed.
Jayasekera
Samantha
S
School of Biological and Chemical Sciences, Birkbeck College University of London, London WC1E 7HX, UK 2Diagnostic Parasitology Laboratory, London School of Hygiene and Tropical Medicine, Keppel Street, London, UK 3Department of Dermatology, King's College Hospital, London, UK.
Sissons
James
J
School of Biological and Chemical Sciences, Birkbeck College University of London, London WC1E 7HX, UK 2Diagnostic Parasitology Laboratory, London School of Hygiene and Tropical Medicine, Keppel Street, London, UK 3Department of Dermatology, King's College Hospital, London, UK.
Tucker
Julie
J
School of Biological and Chemical Sciences, Birkbeck College University of London, London WC1E 7HX, UK 2Diagnostic Parasitology Laboratory, London School of Hygiene and Tropical Medicine, Keppel Street, London, UK 3Department of Dermatology, King's College Hospital, London, UK.
Rogers
Claire
C
School of Biological and Chemical Sciences, Birkbeck College University of London, London WC1E 7HX, UK 2Diagnostic Parasitology Laboratory, London School of Hygiene and Tropical Medicine, Keppel Street, London, UK 3Department of Dermatology, King's College Hospital, London, UK.
Nolder
Debbie
D
School of Biological and Chemical Sciences, Birkbeck College University of London, London WC1E 7HX, UK 2Diagnostic Parasitology Laboratory, London School of Hygiene and Tropical Medicine, Keppel Street, London, UK 3Department of Dermatology, King's College Hospital, London, UK.
Warhurst
David
D
School of Biological and Chemical Sciences, Birkbeck College University of London, London WC1E 7HX, UK 2Diagnostic Parasitology Laboratory, London School of Hygiene and Tropical Medicine, Keppel Street, London, UK 3Department of Dermatology, King's College Hospital, London, UK.
Alsam
Selwa
S
School of Biological and Chemical Sciences, Birkbeck College University of London, London WC1E 7HX, UK 2Diagnostic Parasitology Laboratory, London School of Hygiene and Tropical Medicine, Keppel Street, London, UK 3Department of Dermatology, King's College Hospital, London, UK.
White
Jonathan M L
JML
School of Biological and Chemical Sciences, Birkbeck College University of London, London WC1E 7HX, UK 2Diagnostic Parasitology Laboratory, London School of Hygiene and Tropical Medicine, Keppel Street, London, UK 3Department of Dermatology, King's College Hospital, London, UK.
Higgins
E M
EM
School of Biological and Chemical Sciences, Birkbeck College University of London, London WC1E 7HX, UK 2Diagnostic Parasitology Laboratory, London School of Hygiene and Tropical Medicine, Keppel Street, London, UK 3Department of Dermatology, King's College Hospital, London, UK.
Khan
Naveed Ahmed
NA
School of Biological and Chemical Sciences, Birkbeck College University of London, London WC1E 7HX, UK 2Diagnostic Parasitology Laboratory, London School of Hygiene and Tropical Medicine, Keppel Street, London, UK 3Department of Dermatology, King's College Hospital, London, UK.
D000562:Amebiasis / Q000469:parasitology*; D000656:Amoeba / Q000302:isolation & purification*; D000818:Animals; D001812:Blood-Brain Barrier; D001921:Brain / Q000098:blood supply / Q000469:parasitology*; D020808:Central Nervous System Protozoal Infections / Q000469:parasitology*; D002555:Cerebrospinal Fluid / Q000469:parasitology*; D042783:Endothelial Cells / Q000469:parasitology*; D006099:Granuloma / Q000469:parasitology*; D006801:Humans; D010215:Papio; D016133:Polymerase Chain Reaction