PDF(Pubmed)
Abstract：
UNASSIGNED: Free-living amoebae rarely instigate intracranial infections that may resemble neoplastic conditions on imaging. Naegleria fowleri precipitates an acute, swiftly fatal meningoencephalitis, whereas Acanthamoeba and Balamuthia species typically manifest with a less aggressive onset but carry equally dire consequences.
UNASSIGNED: The case describes a 33-year-old woman with subacute encephalitis caused by Balamuthia mandrillaris. She experienced 2 months of back pain, 1 month of headaches, and 2 weeks of vomiting without fever, recent travel, aquatic activities, or animal exposure. Brain magnetic resonance imaging revealed a sizable, heterogeneous enhancing mass in the right temporal and frontal lobes, accompanied by vasogenic edema and midline shift. Histopathology showed marked inflammation and damage to blood vessels with amoebic trophozoites present. The trophozoites displayed specific characteristics, leading to the diagnosis of amoebic meningoencephalitis. Polymerase chain reaction and Sanger sequencing confirmed B. mandrillaris infection while testing for N. fowleri and Acanthamoeba was negative. Despite antibiotic treatment, the patient\'s condition deteriorated rapidly, resulting in death within 2 weeks of presentation.
UNASSIGNED: This is the first confirmed case of B. mandrillaris central nervous system (CNS) infection from Pakistan. The incidence of this disease is expected to rise due to increasing temperatures due to climate change and the deteriorating quality of the water supply. Balamuthia meningoencephalitis should, therefore be on the differential for non-neoplastic CNS lesions. Furthermore, an atypical histopathologic picture, including the absence of granulomatous inflammation, needs to be recognized.
UNASSIGNED: The case describes a 33-year-old woman with subacute encephalitis caused by Balamuthia mandrillaris. She experienced 2 months of back pain, 1 month of headaches, and 2 weeks of vomiting without fever, recent travel, aquatic activities, or animal exposure. Brain magnetic resonance imaging revealed a sizable, heterogeneous enhancing mass in the right temporal and frontal lobes, accompanied by vasogenic edema and midline shift. Histopathology showed marked inflammation and damage to blood vessels with amoebic trophozoites present. The trophozoites displayed specific characteristics, leading to the diagnosis of amoebic meningoencephalitis. Polymerase chain reaction and Sanger sequencing confirmed B. mandrillaris infection while testing for N. fowleri and Acanthamoeba was negative. Despite antibiotic treatment, the patient\'s condition deteriorated rapidly, resulting in death within 2 weeks of presentation.
UNASSIGNED: This is the first confirmed case of B. mandrillaris central nervous system (CNS) infection from Pakistan. The incidence of this disease is expected to rise due to increasing temperatures due to climate change and the deteriorating quality of the water supply. Balamuthia meningoencephalitis should, therefore be on the differential for non-neoplastic CNS lesions. Furthermore, an atypical histopathologic picture, including the absence of granulomatous inflammation, needs to be recognized.
摘要：
■自由生活的变形虫很少引起颅内感染，这可能类似于影像学上的肿瘤。鸡只Naegleria沉淀出一种急性，迅速致命的脑膜脑炎，而棘阿米巴和Balamuthia物种通常表现为较少的侵略性发作，但具有同样可怕的后果。
该病例描述了一名33岁的女性，患有由Balamuthiamandrillaris引起的亚急性脑炎。她经历了两个月的背痛，头痛1个月,呕吐2周不发烧，最近的旅行,水生活动，或动物暴露。脑部磁共振成像显示，右侧颞叶和额叶的异质性增强肿块，伴有血管源性水肿和中线移位。组织病理学显示存在阿米巴滋养体的明显炎症和血管损伤。滋养体表现出特定的特征，导致诊断为阿米巴脑膜脑炎。聚合酶链反应和Sanger测序证实了曼肩芽孢杆菌感染，而福氏芽孢杆菌和棘阿米巴的检测结果为阴性。尽管有抗生素治疗,病人的病情迅速恶化，导致在陈述后2周内死亡。
■这是巴基斯坦首例确认的曼肩芽孢杆菌中枢神经系统（CNS）感染病例。由于气候变化和供水质量恶化导致的温度升高，预计这种疾病的发病率将上升。Balamuthia脑膜脑炎应该，因此，对于非肿瘤性中枢神经系统病变是有区别的。此外，一张非典型的组织病理学照片,包括没有肉芽肿性炎症，需要得到承认。
该病例描述了一名33岁的女性，患有由Balamuthiamandrillaris引起的亚急性脑炎。她经历了两个月的背痛，头痛1个月,呕吐2周不发烧，最近的旅行,水生活动，或动物暴露。脑部磁共振成像显示，右侧颞叶和额叶的异质性增强肿块，伴有血管源性水肿和中线移位。组织病理学显示存在阿米巴滋养体的明显炎症和血管损伤。滋养体表现出特定的特征，导致诊断为阿米巴脑膜脑炎。聚合酶链反应和Sanger测序证实了曼肩芽孢杆菌感染，而福氏芽孢杆菌和棘阿米巴的检测结果为阴性。尽管有抗生素治疗,病人的病情迅速恶化，导致在陈述后2周内死亡。
■这是巴基斯坦首例确认的曼肩芽孢杆菌中枢神经系统（CNS）感染病例。由于气候变化和供水质量恶化导致的温度升高，预计这种疾病的发病率将上升。Balamuthia脑膜脑炎应该，因此，对于非肿瘤性中枢神经系统病变是有区别的。此外，一张非典型的组织病理学照片,包括没有肉芽肿性炎症，需要得到承认。
