Liang Yuhan, Liu Yanhong, Chen Zelong, Sun Jiayi, Zhang Xuemeng, Wang Yulin
Department of Radiology, The First Medical Center, Chinese PLA General Hospital, Beijing China.
Radiol Case Rep. 2025 Mar 18;20(6):2820-2824. doi: 10.1016/j.radcr.2025.02.035. eCollection 2025 Jun.
Balamuthia amoebic encephalitis (BAE) is a rare and often fatal central nervous system (CNS) infection caused by Balamuthia mandrillaris, a free-living amoeba typically found in soil and water. This organism can invade the brain directly, bypassing other organs, making early diagnosis particularly challenging. Symptoms often do not appear as distinctive early warning signs, and many patients do not experience noticeable skin lesions or systemic symptoms before neurological manifestations emerge. Balamuthia can enter the body through various routes, including the respiratory tract, skin, or gastrointestinal tract, eventually crossing the blood-brain barrier and causing aggressive encephalitis. The early symptoms of BAE are nonspecific, and the disease has an extremely high mortality rate. This report presents a 35-year-old male patient who died from Balamuthia amoebic encephalitis. The patient had a history of prolonged exposure to underground mines and consumed raw beef a week before the onset of symptoms. The infection is believed to have entered through the respiratory tract or gastrointestinal route. Diagnosis was primarily based on pathological findings, and the patient did not receive effective treatment due to delayed diagnosis, ultimately passing away approximately 2 months after the onset of symptoms. This case emphasizes the rarity and fatal nature of BAE, particularly when neurological symptoms are the first sign of infection without preceding systemic or dermatological manifestations. The report highlights the importance of considering Balamuthia mandrillaris infection in patients presenting with unexplained encephalitis and brain abscess, especially with a potential history of exposure to amoeba-contaminated environments.
巴拉姆希阿米巴脑炎（BAE）是一种由曼氏巴拉姆希阿米巴引起的罕见且通常致命的中枢神经系统（CNS）感染，曼氏巴拉姆希阿米巴是一种通常存在于土壤和水中的自由生活阿米巴。这种病原体可直接侵入大脑，绕过其他器官，这使得早期诊断极具挑战性。症状通常不会表现为明显的早期预警信号，许多患者在出现神经症状之前没有明显的皮肤病变或全身症状。巴拉姆希阿米巴可通过多种途径进入人体，包括呼吸道、皮肤或胃肠道，最终穿过血脑屏障并引发侵袭性脑炎。BAE的早期症状不具有特异性，且该疾病的死亡率极高。本报告介绍了一名35岁男性患者，他死于巴拉姆希阿米巴脑炎。该患者有长期接触地下矿井的病史，在症状出现前一周食用了生牛肉。据信感染是通过呼吸道或胃肠道途径进入的。诊断主要基于病理结果，由于诊断延误，患者未接受有效治疗，最终在症状出现后约2个月去世。该病例强调了BAE的罕见性和致命性，尤其是当神经症状是感染的首发症状而无先前的全身或皮肤表现时。该报告强调了在出现不明原因脑炎和脑脓肿的患者中考虑曼氏巴拉姆希阿米巴感染的重要性，特别是有接触受阿米巴污染环境潜在病史的患者。
