Diagnosing Balamuthia mandrillaris encephalitis via next-generation sequencing in a 13-year-old girl

Xia, Wu; Yan, Gangfeng; Han, Shuzhen; Ye, Yingzi; Cheng, Xunjia; Gong, Hairong; Yu, Hui

doi:10.1080/22221751.2020.1775130

Cited by 28 publications

(28 citation statements)

References 45 publications

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“…However, at that time, we were not able to identify the organism and mistakenly thought that they were bacterial infections [32]. In addition to our report, only two cases have been described recently in China [28,29]. Given the huge population in China, it can be inferred that the disease is exceedingly rare.…”

Section: Discussioncontrasting

confidence: 50%

“…In US report, most patients exhibited mildly elevated white blood cell counts with lymphocytic predominance, elevated protein levels, and low-to-normal glucose levels; however, the cerebrospinal fluid profile did not distinguish Balamuthia mandrillaris encephalitis from other kinds of encephalitis [10]. According to recent reports from China, two patients were diagnosed using next-generation sequencing of cerebrospinal fluid [28,29]. Next-generation sequencing of cerebrospinal fluid examination is a non-invasive and fast method to diagnosis amoebic encephalitis; however, the sensitivity and specificity to diagnose early amoebic encephalitis needs to be tested in large case serials.…”

Section: Discussionmentioning

confidence: 98%

“…Some cases have also been reported in the Asia-Pacific region, including Japan [ 15–19 ], India [ 20–22 ], Thailand [ 23 , 24 ], Australia [ 25 , 26 ], and South Korea [ 27 ]. Recently, two cases were reported in China [ 28 , 29 ]. In this study, we describe 28 cases of Balamuthia mandrillaris infection collected in our department during the past 20 years.…”

Section: Introductionmentioning

confidence: 99%

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Balamuthia mandrillaris infection in China: a retrospective report of 28 cases

Wang

Cheng

et al. 2020

Emerging Microbes & Infections

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Balamuthia mandrillaris infection is a rare and fatal disease. We have recorded 28 cases of Balamuthia mandrillaris infection during the past 20 years. Eighteen patients (64%) were male and 10 (36%) were female. Patient age ranged from 3 to 74 (mean, 27) years. Patient locations were distributed among 12 Provinces in China. Twenty-seven (96%) patients lived in rural areas, and 17 (61%) patients reported a history of trauma before the appearance of skin lesions. All cases presented with skin lesions as the primary symptom, and 16 (57%) cases developed encephalitis. Histopathology of skin lesions revealed granulomatous changes with histiocytes, lymphocytes, and plasma cells infiltration. Amebas were identified in all cases with immunohistochemical staining. Follow-up information was available in 27 (96%) cases. Fifteen (56%) patients died due to encephalitis and 12 (44%) were free of disease after treatment. Our results show that the clinical characteristics of Balamuthia mandrillaris infection in China are very different from those in the US. Infection of traumatized skin may play an important role in the pathogenesis of the disease in China. Encephalitis usually develops 3-4 years after skin lesions in Chinese cases. Patients with only skin lesions have a higher cure rate than patients with encephalitis.

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Section: Discussioncontrasting

confidence: 50%

Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

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Balamuthia mandrillaris infection in China: a retrospective report of 28 cases

Wang

Cheng

et al. 2020

Emerging Microbes & Infections

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“…[ 39 ] Recently, several reports have described the use of NGS in confirming B. mandrillaris infection by targeting 18S rRNA and 16S rRNA genes. [ 39 77 78 79 80 ] In addition, matrix-assisted laser desorption/ionization–time-of-flight mass spectrometry can be employed as a rapid diagnostic tool to identify characteristic protein patterns of B. mandrillaris ranging from 2 to 14 kDa. [ 43 ]…”

Section: Laboratory Diagnosismentioning

confidence: 99%

“…In the case of BAE, the differential diagnosis is with neurotuberculosis, neurocysticercosis, fungal infections, neoplasms, viral meningoencephalitis, and acute disseminated encephalomyelitis. [ 12 78 ]…”

Section: Laboratory Diagnosismentioning

confidence: 99%

Balamuthia mandrillaris

Bhosale

Parija

2021

Tropical Parasitology

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Balamuthia mandrillaris is an opportunistic, free-living ameba that is pathogenic to humans. It has a worldwide distribution but is mainly detected in warmer regions. Balamuthia infections are rare but have been reported in both immunocompetent and immunocompromised individuals of all ages. B. mandrillaris can enter through wounds on the skin or the nose and cause cutaneous lesions and the usually fatal Balamuthia amebic encephalitis (BAE). Infection usually spreads from the lungs or through nerve fibers, and attacks the central nervous system, forming granulomatous lesions and necrosis in the brain. Balamuthia infection is usually chronic, and patients initially present with nonspecific symptoms, including headache, nausea, myalgia, and low-grade fever. As the disease progresses, the patient becomes paralyzed and comatose, often leading to death. Lack of knowledge of predisposing factors, specific treatment, and standardized detection tools have resulted in a nearly cent percent fatality rate. Although only about 200 cases have been reported worldwide since its characterization in the 1990s, the number of reported cases has increased over the years. BAE is an emerging disease and a major health concern. Few patients have survived Balamuthia infections with antimicrobial treatment that has largely been empirical. Early diagnosis is the key and requires familiarity with the disease and a high degree of suspicion on the part of the diagnostician. There are currently no specific treatment and prevention recommendations. This review highlights our current understanding of B. mandrillaris in terms of its pathogenicity, genomics, and novel diagnostic and therapeutic approaches against BAE infections.

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Applications of medicinal chemistry for drug discovery against Acanthamoeba infections

Ahmed

Anwar

Ong

et al. 2021

Medicinal Research Reviews

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Acanthamoeba is a genus of free‐living amoebae, pervasively found in the environment. Most of its pathogenic species are the causative agent of sight‐threatening Acanthamoeba keratitis and fatal granulomatous amoebic encephalitis. Despite the advancements in the field of chemotherapy, treating Acanthamoeba infections is still challenging due to incomplete knowledge of the complicated pathophysiology. In case of infection, the treatment regimen for the patients is often ineffective due to delayed diagnosis, poor specificity, and side‐effects. Besides the resistance of Acanthamoeba cysts to most of the drugs, the recurrence of infection further complicates the recovery. Thus, it is necessary to develop an effective treatment which can eradicate these rare, but serious infections. Based on various computational and in vitro studies, it has been established that the synthetic scaffolds such as heterocyclic compounds may act as potential drug leads for the development of antiamoebic drugs. In this review, we report different classes of synthetic compounds especially heterocyclic compounds which have shown promising results against Acanthamoeba. Moreover, the antiamoebic activities of synthetic compounds with their possible mode of actions against Acanthamoeba, have been summarized and discussed in this review.

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Diagnosing Balamuthia mandrillaris encephalitis via next-generation sequencing in a 13-year-old girl

Cited by 28 publications

References 45 publications

Balamuthia mandrillaris infection in China: a retrospective report of 28 cases

Balamuthia mandrillaris infection in China: a retrospective report of 28 cases

Balamuthia mandrillaris

Applications of medicinal chemistry for drug discovery against Acanthamoeba infections

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