Mani Valli, Hudgins Eric
Drexel University College of Medicine, United States.
Reading Hospital, United States.
IDCases. 2021 Jun 8;25:e01174. doi: 10.1016/j.idcr.2021.e01174. eCollection 2021.
is a free-living amoeba that may result in a disseminated infection of the central nervous system called granulomatous amoebic encephalitis. We present a case of balamuthiasis in a Hispanic male with poorly controlled type 2 diabetes mellitus (hemoglobin A1C of 12.2 %) who did not have access to healthcare. He initially presented with the non-specific symptoms of blurry vision, headache and imbalance which rapidly progressed to altered mental status over two months. Imaging revealed multiple peripherally enhancing lesions throughout the cerebellum and cortical regions which corresponded to the patient's deficits. Brain biopsy showed amoebic forms consistent with and later confirmed with cerebrospinal fluid PCR. Our patient was treated with a combination of various antimicrobials, including azithromycin, fluconazole, flucytosine, sulfadiazine, and miltefosine. Unfortunately, his prognosis continued to worsen and he ultimately died after being placed on comfort care.
是一种自由生活的变形虫，可能导致中枢神经系统的播散性感染，称为肉芽肿性阿米巴脑炎。我们报告一例巴兰氏虫病病例，患者为西班牙裔男性，2型糖尿病控制不佳（糖化血红蛋白为12.2%），且无法获得医疗保健服务。他最初出现视力模糊、头痛和平衡失调等非特异性症状，在两个月内迅速发展为精神状态改变。影像学检查显示小脑和皮质区域有多个周边强化病变，与患者的缺陷相对应。脑活检显示阿米巴形态与……一致，后来经脑脊液聚合酶链反应证实。我们的患者接受了多种抗菌药物联合治疗，包括阿奇霉素、氟康唑、氟胞嘧啶、磺胺嘧啶和米替福新。不幸的是，他的预后继续恶化，最终在接受舒适护理后死亡。
