An acute case of granulomatous amoebic encephalitis-Balamuthia mandrillaris infection

Kentarou Takei, Masaya Toyoshima, Masashi Nakamura, Mineshige Sato, Hiroshi Shimizu, Chihiro Inoue, Yoshio Shimizu, Kenji Yagita

Research output: Contribution to journalArticlepeer-review

11 Citations (Scopus)


A 74-year-old woman who exhibited drowsiness was referred to our hospital. Enhanced head magnetic resonance imaging (MRI) revealed multiple ring-enhancing lesions and lesions showing partial mild hemorrhaging. The patient gradually progressed to a comatose condition with notable brain deterioration of unknown cause on follow-up MRI. On day nine, the patient inexplicably died, although brain herniation was suspected. Autopsy and histopathology revealed numerous amoebic trophozoites in the perivascular spaces and within the necrotic tissue. Brain immunostaining tested positive for Balamuthia mandrillaris. Infection due to free-living amoeba is rare in Japan; however, it may increase in the near future due to unknown reasons.

Original languageEnglish
Pages (from-to)1313-1316
Number of pages4
JournalInternal Medicine
Issue number9
Publication statusPublished - 2018


  • Balamuthia mandrillaris
  • CNS infection
  • Granulomatous amoebic encephalitis

ASJC Scopus subject areas

  • Internal Medicine


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