Granulomatous amoebic encephalitis history and symptoms

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Granulomatous amoebic encephalitis is a central nervous system disease caused by certain species of amoeba, especially Balamuthia mandrillaris.

History and symptoms

• Headache
• Low-grade fever
• Mood swings
• Lethargy
• Confusion
• Seizures
• Focal neurological deficits (such as hemiparesis or cranial neuropathy)
• Meningeal irritation (such as stiff neck)

Symptoms of increased intracranial pressure such as nausea and vomiting are common

Disease

Balamuthia infection is very rare. The Balamuthia amebas can infect the skin, sinuses, brain and other organs of the body. Therefore, Balamuthia infection can cause a wide range of symptoms. Disease can begin with a skin wound on the face, trunk, or limbs and can then progress to the brain where it cause a disease called Granulomatous Amebic Encephalitis (GAE)[1,2]. Diagnosis of Balamuthia GAE can be difficult, but some early symptoms may include:

Headaches Stiff neck or head and neck pain with neck movement Sensitivity to light Nausea Vomiting Lethargy (tiredness) Low-grade fever

Other signs of Balamuthia GAE may include:

Behavioral changes Seizures Weight loss Partial paralysis Speech difficulties Difficulty walking

Balamuthia can also cause a widespread infection involving multiple body parts.

The disease might appear mild at first but can become more severe over weeks to several months[1,3]. Often the disease is fatal[3], with a death rate of more than 95%[4]. Overall, the outlook for people who get this disease is poor, although early diagnosis and treatment may increase the chances for survival[4].

References

Perez MT, Bush LM. Fatal amebic encephalitis caused by Balamuthia mandrillaris in an immunocompetent host: a clinicopathological review of pathogenic free-living amebae in human hosts. Ann Diagn Pathol. Dec 2007;11(6):440-447.

Maciver SK. The threat from Balamuthia mandrillaris. J Med Microbiol. Jan 2007;56(Pt 1):1-3.

Visvesvara GS, Moura H, Schuster FL. Pathogenic and opportunistic free-living amoebae: Acanthamoeba spp. , Balamuthia mandrillaris, Naegleria fowleri, and Sappinia diploidea. FEMS Immunol Med Microbiol. Jun 2007;50(1):1-26.

Siddiqui R, Khan NA. Balamuthia amoebic encephalitis: an emerging disease with fatal consequences. Microb Pathog. Feb 2008;44(2):89-97.

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