Department of Pathology, University of Arizona College of Medicine, Tucson.
Department of Pediatrics, University of Arizona College of Medicine, Tucson.
J Pediatric Infect Dis Soc. 2018 Aug 17;7(3):e163-e168. doi: 10.1093/jpids/pix089.
Balamuthia mandrillaris is a recently described ameba known to cause a subacute to chronic central nervous system infection called granulomatous amebic encephalitis. Evidence suggests that apparently immunocompetent persons are at risk for disease and show a similar nonspecific presentation to that of immunodeficient persons. However, evidence of hematogenous dissemination, which has been found in immunodeficient patients, has been lacking in immunocompetent patients. Here, we describe a previously healthy patient with B mandrillaris-associated granulomatous amebic encephalitis in whom both central nervous system and renal disease were found during autopsy, which suggests hematogenous dissemination. We also provide a comprehensive review of the pediatric literature on this disease and its clinical presentation in children.
曼氏迭宫绦虫是一种最近被描述的变形虫，已知会引起一种称为肉芽肿性阿米巴脑炎的亚急性至慢性中枢神经系统感染。有证据表明，表面上免疫功能正常的人也有患病风险，其表现与免疫功能低下的人相似，均为非特异性。然而，在免疫功能低下的患者中发现的血源性播散的证据，在免疫功能正常的患者中却一直缺乏。在这里，我们描述了一例先前健康的曼氏迭宫绦虫相关肉芽肿性阿米巴脑炎患者，尸检时发现中枢神经系统和肾脏疾病，提示存在血源性播散。我们还对该疾病的儿科文献进行了全面回顾，并介绍了其在儿童中的临床表现。
