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Volume 29, Number 1—January 2023

Dispatch

Successful Treatment of Balamuthia mandrillaris Granulomatous Amebic Encephalitis with Nitroxoline

Natasha SpottiswoodeComments to Author , Douglas Pet, Annie Kim, Katherine Gruenberg, Maulik Shah, Amrutha Ramachandran, Matthew T. Laurie, Maham Zia, Camille Fouassier, Christine L. Boutros, Rufei Lu, Yueyuan Zhang, Venice Servellita, Andrew Bollen, Charles Y. Chiu, Michael R. Wilson, Liza Valdivia1, and Joseph L. DeRisi1
Author affiliations: University of California, San Francisco, California, USA (N. Spottiswoode, D. Pet, A. Kim, K. Gruenberg, M. Shah, Amrutha Ramachandran, Matthew T. Laurie, Maham Zia, Camille Fouassier, Christine L. Boutros, Rufei Lu, Yueyuan Zhang, Venice Servellita, Andrew Bollen, Charles Y. Chiu, Michael R. Wilson, Liza Valdivia, Joseph L. DeRisi); Chan Zuckerberg Biohub, San Francisco (Joseph L. DeRisi)

Main Article

Figure 2

Diagnostic findings for patient with granulomatous amebic encephalitis, California, USA. A) Brain biopsy sample. Granulomas are noted in a perivascular pattern. Scattered structures (arrows) with large nuclei and abundant cytoplasma are concerning for amebic trophozoite forms. Occasional structures with a large nucleus present within a relatively rigid outline (lower right image) are suspicious for amebic cysts, the dormant, thick-walled life stage. B) Magnetic resonance images obtained before and after nitroxoline treatment. Upper row shows axial gadolinium-enhanced T1-weighted images; lower row shows axial fluid-attenuated inversion recovery images. Images in the left series were obtained on day 96 after initial visit, 1 week before nitroxoline initiation; images in the right series were obtained on day 156 after initial visit, 7 weeks after nitroxoline initiation. BV, blood vessel.

Figure 2. Diagnostic findings for patient with granulomatous amebic encephalitis, California, USA. A) Brain biopsy sample. Granulomas are noted in a perivascular pattern. Scattered structures (arrows) with large nuclei and abundant cytoplasma are concerning for amebic trophozoite forms. Occasional structures with a large nucleus present within a relatively rigid outline (lower right image) are suspicious for amebic cysts, the dormant, thick-walled life stage. B) Magnetic resonance images obtained before and after nitroxoline treatment. Upper row shows axial gadolinium-enhanced T1-weighted images; lower row shows axial fluid-attenuated inversion recovery images. Images in the left series were obtained on day 96 after initial visit, 1 week before nitroxoline initiation; images in the right series were obtained on day 156 after initial visit, 7 weeks after nitroxoline initiation. BV, blood vessel.

Main Article

1These authors contributed equally to this article.

Page created: November 30, 2022
Page updated: December 22, 2022
Page reviewed: December 22, 2022
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