Granulomatous amoebic encephalitis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Pathophysiology
Diagnosis
History & Symptoms
CT
Magnetic resonance imaging (MRI) scans may show increased signal on T2-weighted images. The lesions may show ring enhancement with intravenous contrast studies. Occasionally, there are neuroradiographic findings of an expanding intracranial mass that may mimic a cerebral tumor or a brain abscess.
Appearance on Biopsy
A brain biopsy will reveal the presence of infection by pathogenic amoebas. In GAE, these present as general inflammation and sparse granules. On microscopic examination, infiltrates of amoebic cysts and/or trophozoites will be visible.
Cerebrospinal Fluid
The CSF demonstrates a lymphocytic pleocytosis, with mildly elevated protein and normal glucose, but diagnostic organisms are not readily identified. Lumbar puncture is contraindicated if there are signs and symptoms of an increase in intracranial pressure.
Treatment
Medical Therapy
GAE can, in general, must be treated by killing the pathogenic amoebas which cause it. Even with treatment, the condition is often fatal, and there are very few recorded survivors, almost all of whom suffered permanent neurocognitive deficits. Several drugs have been shown to be effective against GAE-causing organisms in vitro.[1]
References
External links
- Intalapaporn P, Suankratay C, Shuangshoti S, Phantumchinda K, Keelawat S, Wilde H (2004). "Balamuthia mandrillaris meningoencephalitis: the first case in southeast Asia". Am. J. Trop. Med. Hyg. 70 (6): 666–9. PMID 15211011.