Parasitology Research

, Volume 108, Issue 4, pp 1069–1073

Another case of canine amoebic meningoencephalitis—the challenges of reaching a rapid diagnosis

  • Priscilla J. Hodge
  • Kylie Kelers
  • Robin B. Gasser
  • Govinda S. Visvesvara
  • Sandra Martig
  • Sam N. Long
Short Communication

Abstract

A case of granulomatous amoebic meningoencephalitis in a previously healthy, mature, apparently immunocompetent dog, with a history of exposure to stagnant water, is reported. The case presented with ataxia and a tendency to fall to the left side. A computed tomography (CT) showed a ring-enhancing lesion within the cerebellum; an examination of cerebrospinal fluid (CSF) revealed nonspecific mixed-cell pleocytosis. Despite antibiotic and anti-inflammatory therapy, clinical signs progressed rapidly to decerebellate rigidity over 4 days, and the dog was euthanased. Significant post-mortem findings were restricted to the brain, with a localised lytic lesion in the deep cerebellar white matter. Histopathological examination of the brain showed focally extensive cavitation of the white matter and communication of the lesion with the fourth ventricle. The affected area contained structures consistent with amoebae and was infiltrated by neutrophils mixed with lower numbers of macrophages, plasma cells and lymphocytes. The amoebae were identified as Balamuthia mandrillaris, based on specific immunofluorescence detection. Amoebic meningeoencephalitis should be considered in dogs with evidence of focal cavitary lesions in the brain, particularly in cases with a history of swimming in stagnant water.

References

  1. Bodi I, Dutt N, Hampton T, Akbar N (2008) Fatal granulomatous amoebic meningoencephalitis due to Balamuthia mandrillaris. Pathol Res Pract 204:925–928PubMedCrossRefGoogle Scholar
  2. Canfield PJ, Vogelnest L, Cunningham ML, Visvesvara GS (1997) Amoebic meningoencephalitis caused by Balamuthia mandrillaris in an orang utan. Aust Vet J 75:97–100PubMedCrossRefGoogle Scholar
  3. Deetz TR, Sawyer MH, Billman G, Schuster FL, Visvesvara GS (2003) Successful treatment of Balamuthia amoebic encephalitis: presentation of 2 cases. Clin Infect Dis 37:1304–1312PubMedCrossRefGoogle Scholar
  4. Denney CF, Iragui VJ, Uber-Zak LD, Karpinski NC, Ziegler EJ, Visvesvara GS, Reed SL (1997) Amebic meningoencephalitis caused by Balamuthia mandrillaris: case report and review. Clin Infect Dis 25:1354–1358PubMedCrossRefGoogle Scholar
  5. Dunnebacke TH, Schuster FL, Yagi S, Booton GC (2004) Balamuthia mandrillaris from soil samples. Microbiology 150:2837–2842PubMedCrossRefGoogle Scholar
  6. Finnin PJ, Visvesvara GS, Campbell BE, Fry DR, Gasser RB (2007) Multifocal Balamuthia mandrillaris infection in a dog in Australia. Parasitol Res 100:423–426PubMedCrossRefGoogle Scholar
  7. Foreman O, Sykes J, Ball L, Yang N, De Cock H (2004) Disseminated infection with Balamuthia mandrillaris in a dog. Vet Pathol 41:506–510PubMedCrossRefGoogle Scholar
  8. Glaser C, Schuster F, Yagi S, Gavali S, Bollen A, Raghavan R, Michelson D, Blomquist I, Scharnhorst D, Kuriyama S, Reed S, Ginsberg M, Visvesvara G, Wilkins P, Anderson L, Khetsuriani N, Fowlkes AL (2008) Balamuthia amebic encephalitis—California, 1999–2007. MMWR Morb Mortal Wkly Rep 57:768–771Google Scholar
  9. Healy JF (2002) Balamuthia amebic encephalitis: radiographic and pathologic findings. Am J Neuroradiol 23:486–489PubMedGoogle Scholar
  10. Huang ZH, Antonio F, Rodney FC (1999) Serum antibodies to Balamuthia mandrillaris, a free-living amoeba recently demonstrated to cause granulomatous amoebic encephalitis. J Infect Dis 179:1305–1308PubMedCrossRefGoogle Scholar
  11. Jung S, Schelper RL, Visvesvara GS, Chang HT (2004) Balamuthia mandrillaris meningoencephalitis in an immunocompetent patient: an unusual clinical course and a favorable outcome. Arch Pathol Lab Med 128:466–468PubMedGoogle Scholar
  12. Kiderlen AF, Laube U (2004) Balamuthia mandrillaris, an opportunistic agent of granulomatous amebic encephalitis, infects the brain via the olfactory nerve pathway. Parasitol Res 94:49–52PubMedCrossRefGoogle Scholar
  13. Kiderlen A, Laube U, Radam E, Tata P (2007) Oral infection of immunocompetent and immunodeficient mice with Balamuthia mandrillaris amebae. Parasitol Res 100:775–782PubMedCrossRefGoogle Scholar
  14. Kinde H, Visvesvara GS, Barr BC, Nordhausen RW, Chiu PHW (1998) Amebic meningoencephalitis caused by Balamuthia mandrillaris (leptomyxid ameba) in a horse. J Vet Diagn Invest 10:378–381PubMedGoogle Scholar
  15. Martinez AJ, Schuster FL, Visvesvara GS (2001) Balamuthia mandrillaris: its pathogenic potential. J Eukaryot Microbiol 48:6S–9SCrossRefGoogle Scholar
  16. Matin A, Siddiqui R, Jayasekera S, Khan NA (2008) Increasing importance of Balamuthia mandrillaris. Clin Microbiol Rev 21:435–448PubMedCrossRefGoogle Scholar
  17. Niyyati M, Lorenzo-Morales J, Rezaeian M, Martin-Navarro CM, Haghi AM, Maciver SK, Valladares B (2009) Isolation of Balamuthia mandrillaris from urban dust, free of known infectious involvement. Parasitol Res 106:279–281PubMedCrossRefGoogle Scholar
  18. Reed RP, Cooke-Yarborough CM, Jaquiery AL, Grimwood K, Kepm Andrew S, Su JC, Forsyth JRL (1997) Fatal granulomatous amoebic encephalitis caused by Balamuthia mandrillaris. Med J Aust 167:82–84PubMedGoogle Scholar
  19. Schuster FL, Dunnebacke TH, Booton GC, Yagi S, Kohlmeier CK, Glaser C, Vugia D, Bakardjiev A, Azimi P, Maddux-Gonzalez M, Martinez AJ, Visvesvara GS (2003) Environmental isolation of Balamuthia mandrillaris associated with a case of amebic encephalitis. J Clin Microbiol 41:3175–3180PubMedCrossRefGoogle Scholar
  20. Schuster FL, Honarmand S, Visvesvara GS, Glaser CA (2006) Detection of antibodies against free-living amoebae Balamuthia mandrillaris and Acanthamoeba species in a population of patients with encephalitis. Clin Infect Dis 42:1260–1265PubMedCrossRefGoogle Scholar
  21. Schuster FL, Visvesvara GS (2004a) Amebae and ciliated protozoa as causal agents of waterborne zoonotic disease. Vet Parasitol 126:91–120PubMedCrossRefGoogle Scholar
  22. Schuster FL, Visvesvara GS (2004b) Free-living amoebae as opportunistic and non-opportunistic pathogens of humans and animals. Int J Parasitol 34:1001–1027PubMedCrossRefGoogle Scholar
  23. Schuster FL, Yagi S, Wilkins PP, Gavali S, Visvesvara GS, Glaser CA (2008) Balamuthia mandrillaris, agent of amebic encephalitis: detection of serum antibodies and antigenic similarity of isolates by enzyme immunoassay. J Eukaryot Microbiol 55:313–320PubMedCrossRefGoogle Scholar
  24. Siddiqui R, Khan NA (2008) Balamuthia amoebic encephalitis: an emerging disease with fatal consequences. Microb Pathog 44:89–97PubMedCrossRefGoogle Scholar
  25. Valverde J, Arrese JE, Pierard GE (2006) Granulomatous cutaneous centrofacial and meningocerebral amebiasis. (Case report). Am J Clin Dermatol 7:267–269PubMedCrossRefGoogle Scholar
  26. Visvesvara GS, Martinez AJ, Schuster FL, Leitch GJ, Wallace SV, Sawyer TK, Anderson M (1990) Leptomyxid ameba, a new agent of amebic meningoencephalitis in humans and animals. J Clin Microbiol 28:2750–2756PubMedGoogle Scholar
  27. Visvesvara GS, Moura H, Schuster FL (2007) Pathogenic and opportunistic free-living amoebae: Acanthamoeba spp., Balamuthia mandrillaris, Naegleria fowleri, and Sappinia diploidea. FEMS Immunol Med Microbiol 50:1–26PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Priscilla J. Hodge
    • 1
  • Kylie Kelers
    • 1
  • Robin B. Gasser
    • 1
  • Govinda S. Visvesvara
    • 2
  • Sandra Martig
    • 1
  • Sam N. Long
    • 1
  1. 1.Department of Veterinary ScienceThe University of MelbourneWerribeeAustralia
  2. 2.The Division of Parasitic Diseases, National Center for Zoonotic, Vector-Borne and Enteric DiseasesCenter for Disease Control and PreventionAtlantaUSA

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