Moriarty Paul, Burke Christopher, McCrossin David, Campbell Robert, Cherian Sarah, Shahab Mohammad Shekeeb, Visvesvara Govinda S, Nourse Clare
Department of Paediatrics
Department of Neurology.
J Pediatric Infect Dis Soc. 2014 Mar;3(1):e4-9. doi: 10.1093/jpids/pit033. Epub 2013 Jul 3.
Balamuthia mandrillaris causes granulomatous amoebic encephalitis, which is frequently fatal. There are few reports of survival in children. A 4-year-old child developed severe meningoencephalitis with multiple intracranial ring-enhancing lesions. Empiric therapy was commenced after a biopsy was performed, and the patient had a good clinical response. Molecular testing and indirect immunofluorescence later confirmed the diagnosis of Balamuthia encephalitis. Diagnosis of Balamuthia encephalitis is often delayed. The literature is reviewed with particular reference to reported survival. Prompt tissue diagnosis and initiation of therapy are common features among survivors. In previous reports, miltefosine was not used to treat children, but it was well tolerated in this case and should be considered as a therapeutic option.
曼氏巴通体可引起肉芽肿性阿米巴脑炎，该病通常致命。儿童存活的报道很少。一名4岁儿童出现严重的脑膜脑炎，伴有多个颅内环形强化病灶。活检后开始经验性治疗，患者临床反应良好。分子检测和间接免疫荧光后来证实了巴通体脑炎的诊断。巴通体脑炎的诊断常常延迟。本文回顾了相关文献，特别提及了报道的存活情况。及时进行组织诊断和开始治疗是幸存者的共同特征。在以前的报道中，米替福新未用于治疗儿童，但在本病例中耐受性良好，应被视为一种治疗选择。
