Treatment

Trophozoites of B. mandrillaris in culture. Photo credit: DPDx, CDC

Although there have been more than 200 cases of Balamuthia infection worldwide, few patients are known to have survived as a result of successful drug treatment^[1,2]. Early diagnosis and treatment might increase the chances for survival^[3].

Drugs used in treating Granulomatous Amebic Encephalitis (GAE) caused by Balamuthia have included a combination of flucytosine, pentamidine, fluconazole, sulfadiazine and either azithromycin or clarithromycin^[1,2,4,5]. Recently, miltefosine in combination with some of these other drugs has shown some promise^[2]. Much more information is needed in treating patients with GAE due to Balamuthia.

References

Perez MT, Bush LM. Balamuthia mandrillaris amebic encephalitis. Curr Infect Dis Rep. Jul 2007;9(4):323-328.
Martinez DY, Seas C, Bravo F, et al. Successful treatment of Balamuthia mandrillaris amoebic infection with extensive neurological and cutaneous involvement. Clin Infect Dis. Jul 15 2010;51(2):e7-11.
Siddiqui R, Khan NA. Balamuthia amoebic encephalitis: an emerging disease with fatal consequences. Microb Pathog. Feb 2008;44(2):89-97.
Cary LC, Maul E, Potter C, et al. Balamuthia mandrillaris meningoencephalitis: survival of a pediatric patient. Pediatrics. Mar 2010;125(3):e699-703.
Drugs for Parasitic Infections: The Medical Letter; 2010.