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Abstract：
BACKGROUND: Balamuthia granulomatous amoebic encephalitis (GAE) is a peculiar parasitic infectious disease of the central nervous system, about 39% of the infected Balamuthia GAE patients were found to be immunocompromised and is extremely rare clinically. The presence of trophozoites in diseased tissue is an important basis for pathological diagnosis of GAE. Balamuthia GAE is a rare and highly fatal infection for which there is no effective treatment plan in clinical practice.
METHODS: This paper reports clinical data from a patient with Balamuthia GAE to improve physician understanding of the disease and diagnostic accuracy of imaging and reduce misdiagnosis. A 61-year-old male poultry farmer presented with moderate swelling pain in the right frontoparietal region without obvious inducement three weeks ago. Head computed tomography(CT) and magnetic resonance imaging(MRI) revealed a space-occupying lesion in the right frontal lobe. Intially clinical imaging diagnosed it as a high-grade astrocytoma. The pathological diagnosis of the lesion was inflammatory granulomatous lesions with extensive necrosis, suggesting amoeba infection. The pathogen detected by metagenomic next-generation sequencing (mNGS) is Balamuthia mandrillaris, the final pathological diagnosis was Balamuthia GAE.
CONCLUSIONS: When a head MRI shows irregular or annular enhancement, clinicians should not blindly diagnose common diseases such as brain tumors. Although Balamuthia GAE accounts for only a small proportion of intracranial infections, it should be considered in the differential diagnosis.
METHODS: This paper reports clinical data from a patient with Balamuthia GAE to improve physician understanding of the disease and diagnostic accuracy of imaging and reduce misdiagnosis. A 61-year-old male poultry farmer presented with moderate swelling pain in the right frontoparietal region without obvious inducement three weeks ago. Head computed tomography(CT) and magnetic resonance imaging(MRI) revealed a space-occupying lesion in the right frontal lobe. Intially clinical imaging diagnosed it as a high-grade astrocytoma. The pathological diagnosis of the lesion was inflammatory granulomatous lesions with extensive necrosis, suggesting amoeba infection. The pathogen detected by metagenomic next-generation sequencing (mNGS) is Balamuthia mandrillaris, the final pathological diagnosis was Balamuthia GAE.
CONCLUSIONS: When a head MRI shows irregular or annular enhancement, clinicians should not blindly diagnose common diseases such as brain tumors. Although Balamuthia GAE accounts for only a small proportion of intracranial infections, it should be considered in the differential diagnosis.
摘要：
背景：Balamuthia肉芽肿性阿米巴脑炎（GAE）是中枢神经系统特有的寄生虫感染性疾病，约39%的受感染的BalamuthiaGAE患者被发现免疫功能低下，在临床上极为罕见。病变组织中滋养体的存在是GAE病理诊断的重要依据。BalamuthiaGAE是一种罕见且高度致命的感染，临床实践中尚无有效的治疗方案。
方法：本文报告1例BalamuthiaGAE患者的临床资料，以提高医师对该病的认识和影像学诊断的准确性，减少误诊。三周前，一名61岁的男性家禽养殖户在右额头顶区域出现中度肿胀疼痛，没有明显的诱因。头部计算机断层扫描（CT）和磁共振成像（MRI）显示右额叶占位病变。初步临床影像学诊断为高级别星形细胞瘤。病理诊断为炎性肉芽肿性病变伴广泛坏死，提示阿米巴感染.通过宏基因组下一代测序（mNGS）检测到的病原体是Balamuthiamandrillaris，最终病理诊断为BalamuthiaGAE。
结论：当头部MRI显示不规则或环状增强时，临床医生不应盲目诊断脑肿瘤等常见疾病。尽管BalamuthiaGAE仅占颅内感染的一小部分，在鉴别诊断中应考虑。
方法：本文报告1例BalamuthiaGAE患者的临床资料，以提高医师对该病的认识和影像学诊断的准确性，减少误诊。三周前，一名61岁的男性家禽养殖户在右额头顶区域出现中度肿胀疼痛，没有明显的诱因。头部计算机断层扫描（CT）和磁共振成像（MRI）显示右额叶占位病变。初步临床影像学诊断为高级别星形细胞瘤。病理诊断为炎性肉芽肿性病变伴广泛坏死，提示阿米巴感染.通过宏基因组下一代测序（mNGS）检测到的病原体是Balamuthiamandrillaris，最终病理诊断为BalamuthiaGAE。
结论：当头部MRI显示不规则或环状增强时，临床医生不应盲目诊断脑肿瘤等常见疾病。尽管BalamuthiaGAE仅占颅内感染的一小部分，在鉴别诊断中应考虑。
