[Central nervous system infection by free-living amebas: report of 3 Venezuelan cases].

Abstract

INTRODUCTION:

Infection of the Central Nervous System by free living amebas is an unusual event, 344 cases have been reported to date. The disease becomes evident in two different clinical fashions: Primary Amebic Meningoencephalitis (PAM) caused by Naegleria fowleri and Granulomatous Amebic Encephalitis (GAE) induced by Spp. of Acanthamoeba and Balamuthia.

CLINICAL CASES:

The authors report three new cases from Venezuela. Case 1. 34 years old man, with a chief complaint of general malaise, headache and fever, a diagnosis of common cold was made and the patient was treated as such, he did not improve and was admitted to the hospital with deterioration of his clinical status; the patient died 10 days after the onset of his illness which was determined to be GAE produced by Balamuthia mandrillaris. Case 2. 8 years old female admitted to the hospital because of fever, headache and generalized seizures of sudden onset; neurocysticercosis was diagnosed and following improvement the patient was discharged and readmitted on two occasions because of relapse and worsening of her illness, she died 2 months after the onset of her disease that was diagnosed by autopsy as GAE due to Balamuthia mandrillaris. Case 3. 16 years old male, previously healthy, who following immersion in a water tank was admitted to the hospital because of meningeal irritation that progressed to coma and death in a 7 day lapse; autopsy revealed PAM by Naegleria fowleri. The two cases of GAE due to Balamuthia mandrillaris occurred in apparently immunocompetent individuals, contrary to the statement that these microorganisms are opportunistic.

CONCLUSION:

We believe that neurological infection by amphizoic amebas is being underdiagnosed, probably due to ignorance regarding this pathology or because of a very low autopsy rate in most countries.

• Authors: R Rodríguez, O Méndez, O Molina, G Luzardo, A J Martínez, G S Visvesvara, J Cardozo
• Journal: Revista de neurologia (Rev Neurol) Vol. 26 Issue 154 Pg. 1005-8 (Jun 1998) ISSN: 0210-0010 [Print] Spain
• Vernacular Title: Infección del sistema nervioso central por amebas de vida libre: comunicación de tres nuevos casos venezolanos.
• PMID: 9658480 (Publication Type: Case Reports, English Abstract, Journal Article)

Topics

• Adolescent
• Adult
• Amebiasis (diagnosis, epidemiology, parasitology)
• Animals
• Child
• Cysticercosis (diagnosis)
• Diagnosis, Differential
• Fatal Outcome
• Female
• Fresh Water (parasitology)
• Granuloma (diagnosis, epidemiology, parasitology)
• Humans
• Male
• Meningoencephalitis (diagnosis, epidemiology, parasitology)
• Naegleria fowleri
• Swimming
• Venezuela (epidemiology)