What is Sappinia?
Sappinia is a free-living ameba (a single-celled living organism) found in the environment. There are two known species of Sappinia: Sappinia diploidea and Sappinia pedata[1-4]. This ameba causes amebic encephalitis, which is an infection of the brain. This infection is similar to those caused by other free-living amebas, such as Naegleria fowleri, Balamuthia mandrillaris, and Acanthamoeba[5,6].
Only one case of amebic encephalitis due to Sappinia infection has been reported worldwide. In 1998, a healthy 38-year-old man from Texas was diagnosed with an infection caused by Sappinia diploidea[4,7,8]. Recently, however, this infection was reidentified as being caused by Sappinia pedata. Although the patient was hospitalized, he survived without any long-term consequences[7,8].
Where is Sappinia found?
- Elk and buffalo feces
- Places where farm animals are known to eat
- Soil containing rotting plants
- Fresh water sources[2-3,5-7]
How is Sappinia infection spread?
It is thought that Sappinia may enter the body through the nose or via cuts and bruises on the body[5-8]. In the only known case , the patient had signs of a sinus infection before developing symptoms of amebic encephalitis[2,5].
There are no reported cases of the spread of Sappinia spreading from one person to another. All free-living amebas can live and multiply in the open environment without entering a human or animal host.
What are the symptoms of a Sappinia infection?
Symptoms of a Sappinia infection include:
- Sensitivity to light
- Nausea or upset stomach
- Blurry vision
- Loss of consciousness
A scan of the one, infected patient’s brain also revealed a 2-centimeter tumor-like mass on the back left section of his brain[2-6].
What is the treatment for Sappinia infection?
Treatment for the one identified case of Sappinia infection included the removal of a tumor in the brain and a series of drugs given to the patient after surgery. This treatment lead to the patient’s full recovery[7,8].
Upon examination of the tumor tissue samples, scientists at the Centers for Disease Control and Prevention (CDC) determined that the species of free-living ameba that caused the infection was Sappinia.
Who is most at risk for Sappinia infection?
Sappinia can infect anyone. However, individuals with weakened immune systems and people who have contact with animal feces (poop) are at a higher risk for infection. A weakened immune system may be the result of AIDS, cancer, liver disease, diabetes mellitus, or drugs used after an organ transplant.
It is likely that most cases of Sappinia infection are not reported because the ameba is hard to identify.
How severe is amebic encephalitis caused by Sappinia?
Infections that involve the brain can be fatal and are often diagnosed late in the disease process; however, amebic encephalitis due to Sappinia was not fatal in the only patient identified so far.
- Walochnik, J., C. Wylezich, and R. Michel, The genus Sappinia: History, phylogeny and medical relevance. Exp Parasitol, 2009.
- Brown, M.W., F.W. Spiegel, and J.D. Silberman, Amoeba at attention: phylogenetic affinity of Sappinia pedata. J Eukaryot Microbiol, 2007. 54(6): p. 511-9.
- Wylezich, C., Walochnik J, Michel, R, High genetic diversity of Sappinia-like strains (Amoebozoa, Thecamoebidae) revealed by SSU rRNA investigations. Parasitol Res, 2009. 105:869–873.
- Page, F.C. A new key to freshwater and soil Gymnamoebae with instructions for culture. Culture Collection of algae and protozoa, Freshwater Biological Association, 1988.
- Visvesvara, G.S., H. Moura, and F.L. Schuster, Pathogenic and opportunistic free-living amoebae: Acanthamoeba spp., Balamuthia mandrillaris, Naegleria fowleri, and Sappinia diploidea. FEMS Immunol Med Microbiol, 2007. 50(1): p. 1-26.
- da Rocha-Azevedo, B., H.B. Tanowitz, and F. Marciano-Cabral, Diagnosis of infections caused by pathogenic free-living amoebae. Interdiscip Perspect Infect Dis, 2009: p. 251-406.
- Gelman, B.B., et al., Amoebic encephalitis due to Sappinia diploidea. JAMA, 2001. 285(19): p. 2450-1.
- Gelman, B.B., et al., Neuropathological and ultrastructural features of amebic encephalitis caused by Sappinia diploidea. J Neuropathol Exp Neurol, 2003. 62(10): p. 990-8.
- Qvarnstrom, Y., et al., Molecular confirmation of Sappinia pedata as a causative agent of amoebic encephalitis. J Infect Dis, 2009. 199(8): p. 1139-42.