Balamuthia mandrillaris meningoencephalitis: survival of a pediatric patient.

Balamuthia mandrillaris infections are rare and almost always fatal. This ameba is a naturally occurring soil inhabitant that can cause disease in immunocompetent hosts, with early diagnosis typically proving difficult. We recently cared for a previously healthy 2-year-old boy who was diagnosed with meningoencephalitis secondary to B mandrillaris relatively early in his presentation, which enabled us to initiate targeted antimicrobial therapy. Since discharge from the hospital the child has shown slow, steady improvement with dramatic improvements seen on follow-up brain imaging. Our observations suggest that early diagnosis and treatment may significantly reduce mortality and morbidity rates from this highly virulent organism.