The authors describe the unique presentation of Balamuthia mandrillaris encephalitis in a kidney donor and two recipients. All three patients suffered acute clinical deterioration, with radiological or clinical evidence of intracranial hypertension. Brain autopsy in the donor and an urgent brain biopsy in a recipient established the diagnosis. Firsttier therapy, with mannitol and CSF drainage, successfully treated the intracranial hypertension in both recipients, while administration of a combination of antiamebic drugs was associated with survival in the second recipient. For both recipients, neurosurgical management played a critical role in the rapid diagnosis and treatment of Balamuthia mandrillaris encephalitis.
Abbreviations used in this paper: EVD = external ventricular drain; GOS = Glasgow Outcome Scale; ICP = intracranial pressure; PCR = polymerase chain reaction; WBC = white blood cell count.
AnzilAPRaoCWrzolekMAVisvesvaraGSSherJHKozlowskiPB: Amebic meningoencephalitis in a patient with AIDS caused by a newly recognized opportunistic pathogen. Leptomyxid ameba. Arch Pathol Lab Med115:21–251991
AnzilAP, RaoC, WrzolekMA, VisvesvaraGS, SherJH, KozlowskiPB: Amebic meningoencephalitis in a patient with AIDS caused by a newly recognized opportunistic pathogen. Leptomyxid ameba. 115:21–25, 1991)| false