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一种机会性自由生活阿米巴——最新综述

: An opportunistic, free-living ameba - An updated review.

作者信息

Bhosale Namrata K, Parija Subhash Chandra

机构信息

Department of Microbiology, Mahatma Gandhi Medical College and Research Institute, Puducherry, India.

Vice Chancellor, Sri Balaji Vidyapeeth, Puducherry, India.

出版信息

Trop Parasitol. 2021 Jul-Dec;11(2):78-88. doi: 10.4103/tp.tp_36_21. Epub 2021 Oct 20.


DOI:10.4103/tp.tp_36_21
PMID:34765527
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8579774/
Abstract

is an opportunistic, free-living ameba that is pathogenic to humans. It has a worldwide distribution but is mainly detected in warmer regions. infections are rare but have been reported in both immunocompetent and immunocompromised individuals of all ages. can enter through wounds on the skin or the nose and cause cutaneous lesions and the usually fatal amebic encephalitis (BAE). Infection usually spreads from the lungs or through nerve fibers, and attacks the central nervous system, forming granulomatous lesions and necrosis in the brain. infection is usually chronic, and patients initially present with nonspecific symptoms, including headache, nausea, myalgia, and low-grade fever. As the disease progresses, the patient becomes paralyzed and comatose, often leading to death. Lack of knowledge of predisposing factors, specific treatment, and standardized detection tools have resulted in a nearly cent percent fatality rate. Although only about 200 cases have been reported worldwide since its characterization in the 1990s, the number of reported cases has increased over the years. BAE is an emerging disease and a major health concern. Few patients have survived infections with antimicrobial treatment that has largely been empirical. Early diagnosis is the key and requires familiarity with the disease and a high degree of suspicion on the part of the diagnostician. There are currently no specific treatment and prevention recommendations. This review highlights our current understanding of in terms of its pathogenicity, genomics, and novel diagnostic and therapeutic approaches against BAE infections.

摘要

是一种机会性自由生活的阿米巴原虫,对人类具有致病性。它在全球范围内分布,但主要在较温暖的地区被检测到。感染很少见,但在各年龄段的免疫功能正常和免疫功能低下的个体中均有报道。它可通过皮肤或鼻子上的伤口进入人体,导致皮肤病变以及通常致命的原发性阿米巴脑膜脑炎(BAE)。感染通常从肺部扩散或通过神经纤维传播,攻击中枢神经系统,在大脑中形成肉芽肿性病变和坏死。感染通常是慢性的,患者最初表现为非特异性症状,包括头痛、恶心、肌痛和低热。随着疾病进展,患者会出现瘫痪和昏迷,常导致死亡。由于对易感因素、特异性治疗和标准化检测工具缺乏了解,导致死亡率几乎达百分之百。自20世纪90年代其特征被描述以来,尽管全球仅报告了约200例病例,但报告病例数多年来一直在增加。BAE是一种新兴疾病,也是一个主要的健康问题。很少有患者在主要基于经验的抗菌治疗后从感染中存活下来。早期诊断是关键,这需要诊断医生熟悉该疾病并保持高度怀疑。目前尚无具体的治疗和预防建议。本综述重点介绍了我们目前对其致病性、基因组学以及针对BAE感染的新型诊断和治疗方法的理解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3328/8579774/33b32fc3fe34/TP-11-78-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3328/8579774/704a47810bea/TP-11-78-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3328/8579774/3cb6d350e8ea/TP-11-78-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3328/8579774/33b32fc3fe34/TP-11-78-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3328/8579774/704a47810bea/TP-11-78-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3328/8579774/3cb6d350e8ea/TP-11-78-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3328/8579774/33b32fc3fe34/TP-11-78-g003.jpg

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本文引用的文献

[1]
infection in China: a retrospective report of 28 cases.

Emerg Microbes Infect. 2020-12

[2]
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Open Forum Infect Dis. 2020-6-1

[3]
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Emerg Microbes Infect. 2020-12

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ACS Chem Neurosci. 2020-8-19

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Int J Parasitol Drugs Drug Resist. 2019-10-22

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mBio. 2018-10-30

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Int J Infect Dis. 2018-9-20

[10]
The Epidemiology and Clinical Features of Balamuthia mandrillaris Disease in the United States, 1974-2016.

Clin Infect Dis. 2019-5-17

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