Granulomatous amoebic encephalitis medical therapy: Difference between revisions

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==Medical therapy==
==Medical therapy==
GAE can, in general, must be treated by killing the pathogenic amoebas which cause it. Even with treatment, the condition is often fatal, and there are very few recorded survivors, almost all of whom suffered permanent [[neurocognitive|neurocognitive deficits]]. Several drugs have been shown to be effective against GAE-causing organisms ''[[in vitro]]''.<ref>http://path.upmc.edu/cases/case156/dx.html</ref>
GAE can, in general, must be treated by killing the pathogenic amoebas which cause it. Even with treatment, the condition is often fatal, and there are very few recorded survivors, almost all of whom suffered permanent [[neurocognitive|neurocognitive deficits]]. Several drugs have been shown to be effective against GAE-causing organisms ''[[in vitro]]''.<ref>http://path.upmc.edu/cases/case156/dx.html</ref>
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.


==References==
==References==

Revision as of 17:02, 3 February 2012

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Granulomatous amoebic encephalitis is a central nervous system disease caused by certain species of amoeba, especially Balamuthia mandrillaris.

Medical therapy

GAE can, in general, must be treated by killing the pathogenic amoebas which cause it. Even with treatment, the condition is often fatal, and there are very few recorded survivors, almost all of whom suffered permanent neurocognitive deficits. Several drugs have been shown to be effective against GAE-causing organisms in vitro.[1]

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.

References


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