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Encephalomyelomeningitis Caused by Balamuthia mandrillaris: A Case Report and Literature Review

Central nervous system infection by Balamuthia mandrillaris is a rare and severe condition, which has a fatality rate of approximately 95% and often evades timely diagnosis due to its rarity and non-specific clinical manifestations. Here, we report a case of encephalomyelomeningitis caused by B. man...

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Autores principales: Fan, XueMei, Chen, TianWen, Yang, Hui, Gao, Yue, Chen, Yan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9901442/
https://www.ncbi.nlm.nih.gov/pubmed/36756612
http://dx.doi.org/10.2147/IDR.S400692
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author Fan, XueMei
Chen, TianWen
Yang, Hui
Gao, Yue
Chen, Yan
author_facet Fan, XueMei
Chen, TianWen
Yang, Hui
Gao, Yue
Chen, Yan
author_sort Fan, XueMei
collection PubMed
description Central nervous system infection by Balamuthia mandrillaris is a rare and severe condition, which has a fatality rate of approximately 95% and often evades timely diagnosis due to its rarity and non-specific clinical manifestations. Here, we report a case of encephalomyelomeningitis caused by B. mandrillaris in a male who presented with transient coma, nausea, and vomiting when working in a garbage dump. Initial magnetic resonance imaging (MRI) of the brain showed normal signals. Despite receiving steroids as well as antibacterial and antiviral treatment, he developed urinary and fecal dysfunction, inability to walk, and deterioration of consciousness. Both brain and spinal cord MRI revealed abnormal findings, and next-generation sequencing of the cerebrospinal fluid showed the presence of B. mandrillaris. A combination of fluconazole and albendazole was administered; however, the patient deteriorated gradually and died 30 days after the onset. We suggest the unbiased metagenomic sequencing of the affected tissues/CSF in patients with CNS infections that are difficult to diagnose or treat, and multiple tests at different stages of the disease may be required.
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spelling pubmed-99014422023-02-07 Encephalomyelomeningitis Caused by Balamuthia mandrillaris: A Case Report and Literature Review Fan, XueMei Chen, TianWen Yang, Hui Gao, Yue Chen, Yan Infect Drug Resist Case Report Central nervous system infection by Balamuthia mandrillaris is a rare and severe condition, which has a fatality rate of approximately 95% and often evades timely diagnosis due to its rarity and non-specific clinical manifestations. Here, we report a case of encephalomyelomeningitis caused by B. mandrillaris in a male who presented with transient coma, nausea, and vomiting when working in a garbage dump. Initial magnetic resonance imaging (MRI) of the brain showed normal signals. Despite receiving steroids as well as antibacterial and antiviral treatment, he developed urinary and fecal dysfunction, inability to walk, and deterioration of consciousness. Both brain and spinal cord MRI revealed abnormal findings, and next-generation sequencing of the cerebrospinal fluid showed the presence of B. mandrillaris. A combination of fluconazole and albendazole was administered; however, the patient deteriorated gradually and died 30 days after the onset. We suggest the unbiased metagenomic sequencing of the affected tissues/CSF in patients with CNS infections that are difficult to diagnose or treat, and multiple tests at different stages of the disease may be required. Dove 2023-02-02 /pmc/articles/PMC9901442/ /pubmed/36756612 http://dx.doi.org/10.2147/IDR.S400692 Text en © 2023 Fan et al. https://creativecommons.org/licenses/by-nc/3.0/This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/ (https://creativecommons.org/licenses/by-nc/3.0/) ). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Case Report
Fan, XueMei
Chen, TianWen
Yang, Hui
Gao, Yue
Chen, Yan
Encephalomyelomeningitis Caused by Balamuthia mandrillaris: A Case Report and Literature Review
title Encephalomyelomeningitis Caused by Balamuthia mandrillaris: A Case Report and Literature Review
title_full Encephalomyelomeningitis Caused by Balamuthia mandrillaris: A Case Report and Literature Review
title_fullStr Encephalomyelomeningitis Caused by Balamuthia mandrillaris: A Case Report and Literature Review
title_full_unstemmed Encephalomyelomeningitis Caused by Balamuthia mandrillaris: A Case Report and Literature Review
title_short Encephalomyelomeningitis Caused by Balamuthia mandrillaris: A Case Report and Literature Review
title_sort encephalomyelomeningitis caused by balamuthia mandrillaris: a case report and literature review
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9901442/
https://www.ncbi.nlm.nih.gov/pubmed/36756612
http://dx.doi.org/10.2147/IDR.S400692
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