title: Balamuthia mandrillaris Encephalitis: Survival of a Child With Severe Meningoencephalitis and Review of the Literature.
abstract: Balamuthia mandrillaris causes granulomatous amoebic encephalitis, which is frequently fatal. There are few reports of survival in children. A 4-year-old child developed severe meningoencephalitis with multiple intracranial ring-enhancing lesions. Empiric therapy was commenced after a biopsy was performed, and the patient had a good clinical response. Molecular testing and indirect immunofluorescence later confirmed the diagnosis of Balamuthia encephalitis. Diagnosis of Balamuthia encephalitis is often delayed. The literature is reviewed with particular reference to reported survival. Prompt tissue diagnosis and initiation of therapy are common features among survivors. In previous reports, miltefosine was not used to treat children, but it was well tolerated in this case and should be considered as a therapeutic option.
authors.affiliation: Department of Paediatrics pauldmoriarty@gmail.com.
authors.forename: Paul
authors.initials: P
authors.lastname: Moriarty
authors.affiliation: Department of Neurology.
authors.forename: Christopher
authors.initials: C
authors.lastname: Burke
authors.affiliation: Department of Paediatrics.
authors.forename: David
authors.initials: D
authors.lastname: McCrossin
authors.affiliation: Department of Neurosurgery, Mater Health Services.
authors.forename: Robert
authors.initials: R
authors.lastname: Campbell
authors.affiliation: Department of Sullivan and Nicolaides Pathology, and.
authors.forename: Sarah
authors.initials: S
authors.lastname: Cherian
authors.affiliation: Department of Neurology, Royal Children's Hospital, Brisbane, Australia.
authors.forename: Mohammad Shekeeb
authors.initials: MS
authors.lastname: Shahab
authors.affiliation: Division of Parasitic Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Govinda S
authors.initials: GS
authors.lastname: Visvesvara
authors.affiliation: Department of Paediatrics University of Queensland, Brisbane, Australia.
authors.forename: Clare
authors.initials: C
authors.lastname: Nourse
keywords: Balamuthia; amoeba; encephalitis; miltefosine