Herdin Record #: PCHRD061807010603

Granulomatous amebic encephalitis in the Philippines.

Researchers

Name Role
1
Mel Michel G. Villaluz Author
2
Martha Lu-Bolanos Author
3
Edwin Munoz Author

Related Institutions

Institutions Name Role

Philippine Children's Medical Center Authors Affiliation

Publication Information

1.
Publication Type : Journal
Publication Sub Type : Announcements
Title: The Philippine Journal of Neurology
Frequency: Semi-Annual
Publication Date: November 2006-November 1999
Volume: 10
Issue: 2
Page(s): 56, 59

2.
Publication Type : Journal
Publication Sub Type : Journal Article, Original
Title: The Philippine Journal of Neurology
Frequency: Semi-Annual
Publication Date: June 2007
Volume: 11
Issue: 1
Page(s): 39-44

Objectives

We report the first documented case of granulomatous amebic encephalitis in our institution, and probablyin the Philippines.
Based on review of previous reports internationally, this may be the youngest patient reported to contract the fatal disease.

Abstract

BACKGROUND: Granulomatous amebic encephalitis is a rare condition. Only less than 200 cases have been reported
worldwide, and only three survivors have been reported to date. Two types of free living ameba are known to cause
granulomatous amebic encephalitis, namely Acanthamoeba spp. and Balamuthia mandrillaris.

OBJECTIVES: We report the first documented case of granulomatous amebic encephalitis in our institution, and probably in
the Philippines. Based on review of previous reports internationally, this may be the youngest patient reported to contract the
fatal disease.
 CASE SUMMARY: We present a case of an 8-month old female infant who initially presented with acute blindness. Cranial
ultrasonography, computed tomography and magnetic resonance imaging all showed multiple calcified intracranial lesions
with progressive malacic changes. In the course of her confinement, the patient rapidly developed seizures, remittent fever and
severe neurological deficits. The patient was unresponsive to anti-koch's therapy, Amphotericin B, Ceftazidime, Amikacin and
Ciprofloxacin. Unfortunately, the patient expired on the 39th hospital day. At post mortem autopsy of the brain, hematoxylin
and eosin stained sections and periodic acid Schiff stain showed diffuse and chronic necrotizing inflammation with numerous
amebic trophozoites surrounding the perivascular area. This confirmed the diagnosis of granulomatous amebic encephalitis.
Morphology of the organisms was further confirmed by electron microscopy. However, PCR for Balamuthia DNAwas
negative.

SIGNIFICANCE: This is the first ever documented case of granulomatous amebic encephalitis in our institution, and also
probably the first case reported in our country. The differential diagnosis of amebic encephalitis should be considered among
patients with CNS infections who are refractory to treatment, even if the patient has no identified risk factors, since this could
affect immunocompetent children.

Physical Location

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