Yamasaki Kouji, Sugimoto Tetsuaki, Futami Munetomo, Moriyama Takuzo, Uehara Hisao, Takeshima Hideo, Moriguchi Sayaka, Marutsuka Kousuke, Asada Yujiro
Department of Neurosurgery, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan.
Neurol Med Chir (Tokyo). 2011;51(9):667-70. doi: 10.2176/nmc.51.667.
A 51-year-old immunocompetent Japanese woman presented with a rare case of granulomatous amoebic encephalitis (GAE) caused by Balamuthia mandrillaris. She was brought to our hospital with epilepsy. Magnetic resonance imaging of the brain revealed a homogeneously enhanced solitary mass in the left frontal lobe. Histological diagnosis was made by a biopsy, which suggested lymphomatoid granulomatosis. After that, her neurological condition got worse. New masses were found and had spread across the whole brain. She died 2 months later of cerebral hernia. Autopsy revealed that the patient had GAE caused by Balamuthia mandrillaris. GAE is usually fatal, and is difficult to diagnose except at autopsy. Therefore, awareness of this disease is important, and earlier diagnosis and the development of a better therapeutic strategy will improve clinical outcome.
一名51岁免疫功能正常的日本女性患上了由曼氏巴通体引起的罕见的肉芽肿性阿米巴脑炎（GAE）。她因癫痫被送至我院。脑部磁共振成像显示左额叶有一个均匀强化的孤立肿块。活检做出了组织学诊断，提示为淋巴瘤样肉芽肿病。此后，她的神经状况恶化。发现了新的肿块，且已扩散至全脑。2个月后她因脑疝死亡。尸检显示该患者患有由曼氏巴通体引起的GAE。GAE通常是致命的，除尸检外难以诊断。因此，认识这种疾病很重要，早期诊断和更好治疗策略的制定将改善临床结局。
