Balamuthia mandrillaris infection

What is it Balamuthia mandrillaris?

Balamuthia mandrillaris (B. mandrillaris) is an amoeba that lives in water and soil. B. mandrillaris It was first discovered in 1990 and has been associated with more than 100 cases of the disease since then. Infection with B. mandrillaris It has been reported in South, Central and North America, Asia, Australia and Europe, but it is still a rare cause of amebiasis.

How B. mandrillaris cause infection?

B. mandrillaris can enter humans through the nose mucous membrane, lungs or breaks in the skin. As in the cases of other free-living amoebas (eg, Naegleria and Acanthamoeba), a story of swimming in freshwater lakes, ponds, and heated pools is common.

Weeks or years later (5 to 8 months on average) the infection spreads to the central nervous system causing amebiasis. encephalitis (inflammation of the brain).

What are the symptoms B. mandrillaris encephalitis?

Characteristics of B. mandrillaris Encephalitis includes:

• Fever
• Focal neurological deficits (eg double vision has been commonly reported)
• Symptoms of meningeal irritation (eg, stiff neck and intolerance to bright light)
• Symptoms of increase intracranial pressure: headache, nausea and vomiting, and reduced level of consciousness.

In the 95% of patients, B. mandrillaris encephalitis is fatal.

How B. mandrillaris infection affects the skin?

The dermatological significance of B. mandrillaris is that a typical skin injury It appears before the infection spreads to the central nervous system. Classical skin injury is a asymptomatic granulomatous license plate (a nodule made of inflammatory cells), generally located on the central face. They are often described as rubbery in consistency. Single or multiple lesions may be present,

The lesion can enlarge (to involve the entire face in some cases) and occasionally causes smaller satellite lesions. Ulceration occurs at a late stage. Occasionally, injury can occur in the extremities.

How is the diagnosis of B. mandrillaris infection made?

How B. mandrillaris infection is very rare, diagnosis is often delayed. The diagnosis is made by finding the amoeba in the skin or other tissue. Biopsy granulomatous tuberculoid specimen infiltrate inside dermis and subcutaneous Trophozoite tissues and cysts are rarely seen.

B. mandrillaris it's hard culture in the laboratory in normal culture media. the organism can be grown in specific mammalian cell culture lines or by inoculation of mice if there is clinical suspicion of Balamuthia infection. A Polymerase chain reaction (PCR) has been developed for research purposes, but is available in some community laboratories.

Treatment of B. Mandrillaris infection

Early treatment with a variety of oral antifungal, anthelmintic, and antiprotozoal medications (often in combination) may improve survival.