Parasites, Hosts and Diseases

The Korea Society for Parasitology and Tropical Medicine (대한기생충학·열대의학회)
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Diagnosing Balamuthia mandrillaris amebic meningoencephalitis in a 64-year-old woman from the Southwest of China

  • Suhua Yao (Department of Medical Microbiology and Immunology, School of Basic Medical Sciences, Dali University) ;
  • Xiaoting Chen (Department of Medical Microbiology and Immunology, School of Basic Medical Sciences, Dali University) ;
  • Lian Qian (Department of Medical Microbiology and Immunology, School of Basic Medical Sciences, Dali University) ;
  • Shizheng Sun (Department of Medical Microbiology and Immunology, School of Basic Medical Sciences, Dali University) ;
  • Chunjing Zhao (Department of Medical Microbiology and Immunology, School of Basic Medical Sciences, Dali University) ;
  • Zongkai Bai (Department of Medical Microbiology and Immunology, School of Basic Medical Sciences, Dali University) ;
  • Zhaofang Chen (Department of Medical Microbiology and Immunology, School of Basic Medical Sciences, Dali University) ;
  • Youcong Wu (Department of Medical Microbiology and Immunology, School of Basic Medical Sciences, Dali University)
  • Received : 2023.03.28
  • Accepted : 2023.04.06
  • Published : 2023.05.31
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Abstract

Balamuthia mandrillaris amebic encephalitis (BAE) can cause a fatal condition if diagnosis is delayed or effective treatment is lacking. Patients with BAE have been previously reported in 12 provinces of China, with skin lesions being the primary symptom and encephalitis developing after several years. However, a significantly lower number of cases has been reported in Southwest China. Here we report an aggressive BAE case of a 64-year-old woman farmer with a history of skin lesions on her left hand. She was admitted to our hospital due to symptoms of dizziness, headache, cough, vomiting, and gait instability. She was initially diagnosed with syphilitic meningoencephalitis and received a variety of empirical treatment that failed to improve her symptoms. Finally, she was diagnosed with BAE combined with amebic pneumonia using next-generation sequencing (NGS), qRT-PCR, sequence analysis, and imaging studies. She died approximately 3 weeks after the onset. This case highlights that the rapid development of encephalitis can be a prominent clinical manifestation of Balamuthia mandrillaris infection.

Keywords

Acknowledgement

We would like to thank the patient's family for participating in the present research study. We would also like to thank Prof. Di Qu and Yang Wu from Fudan University for their helpful discussions, and Prof. Li Bai and Yuanying Shen from Dali University for the case analysis. This work was supported by the National Natural Science Foundation of China (No. 82060380, 81660346 to WYC), and by Young and the Middle-aged Academic Leader Training Foundation of Yunnan Province (No. 202305AC160038 to WYC). All data generated or analyzed during this study were included in this published article and its Supplementary Fig. S1.

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