Abstract：
BACKGROUND: Balamuthia amoebic encephalitis (BAE), caused by Balamuthia mandrillaris, is a rare and life-threatening infectious disease with no specific and effective treatments available. The diagnosis of BAE at an early stage is difficult because of the non-specific clinical manifestations and neuroimaging.
METHODS: A 52-year-old male patient, who had no previous history of skin lesions, presented to the emergency department with an acute headache, walking difficulties, and disturbance of consciousness. The patient underwent a series of examinations, including regular cerebrospinal fluid (CSF) studies and magnetic resonance imaging, and tuberculous meningoencephalitis was suspected. Despite being treated with anti-TB drugs, no clinical improvement was observed in the patient. Following corticosteroid therapy, the patient developed a rapid deterioration in consciousness with dilated pupils. Metagenomic next-generation sequencing (mNGS) revealed an unexpected central nervous system (CNS) amoebic infection, and the patient died soon after the confirmed diagnosis.
CONCLUSIONS: This study highlights the application of mNGS for the diagnosis of patients with suspected encephalitis or meningitis, especially those caused by rare opportunistic infections.
METHODS: A 52-year-old male patient, who had no previous history of skin lesions, presented to the emergency department with an acute headache, walking difficulties, and disturbance of consciousness. The patient underwent a series of examinations, including regular cerebrospinal fluid (CSF) studies and magnetic resonance imaging, and tuberculous meningoencephalitis was suspected. Despite being treated with anti-TB drugs, no clinical improvement was observed in the patient. Following corticosteroid therapy, the patient developed a rapid deterioration in consciousness with dilated pupils. Metagenomic next-generation sequencing (mNGS) revealed an unexpected central nervous system (CNS) amoebic infection, and the patient died soon after the confirmed diagnosis.
CONCLUSIONS: This study highlights the application of mNGS for the diagnosis of patients with suspected encephalitis or meningitis, especially those caused by rare opportunistic infections.
摘要：
背景：Balamuthia变形虫脑炎（BAE），由BalamuthiaMandrillaris引起的，是一种罕见且危及生命的传染病，没有具体有效的治疗方法。由于临床表现和神经影像学的非特异性，BAE的早期诊断很困难。
方法：一名52岁男性患者，以前没有皮肤损伤史的人，急性头痛被送到急诊科，行走困难,和意识障碍。病人接受了一系列的检查,包括常规脑脊液（CSF）研究和磁共振成像，和结核性脑膜脑炎被怀疑。尽管接受了抗结核药物治疗，患者未观察到临床改善.皮质类固醇治疗后，患者的意识迅速恶化，瞳孔散大。宏基因组下一代测序（mNGS）揭示了意外的中枢神经系统（CNS）阿米巴感染，患者在确诊后不久死亡。
结论：本研究强调了mNGS在疑似脑炎或脑膜炎患者诊断中的应用，尤其是那些由罕见的机会性感染引起的。
方法：一名52岁男性患者，以前没有皮肤损伤史的人，急性头痛被送到急诊科，行走困难,和意识障碍。病人接受了一系列的检查,包括常规脑脊液（CSF）研究和磁共振成像，和结核性脑膜脑炎被怀疑。尽管接受了抗结核药物治疗，患者未观察到临床改善.皮质类固醇治疗后，患者的意识迅速恶化，瞳孔散大。宏基因组下一代测序（mNGS）揭示了意外的中枢神经系统（CNS）阿米巴感染，患者在确诊后不久死亡。
结论：本研究强调了mNGS在疑似脑炎或脑膜炎患者诊断中的应用，尤其是那些由罕见的机会性感染引起的。
