|
|
Naegleria fowleri
|
Acanthamoeba species
|
Balamuthia mandrillaris
|
| Clinical presentation
|
Primary amebic meningoencephalitis (PAM), with fulminant disease within days and death within 1-2 weeks
|
Granulomatous amebic encephalitis (GAE), with subacute presentations followed by fatal acute stage; may have cutaneous or sinus lesions; amebic keratitis
|
GAE as well, similarly subacute; may have skin lesions
|
| Risk factors
|
Healthy children or young adults with recreational warm fresh-water exposure
|
Immunocompromised people; contact lens wearers, for keratitis
|
Immunocompromised people, but also immunocompetent children and elderly, and Hispanics
|
| Neuroimaging
|
Nonspecific
|
Space-occupying or ring-enhancing lesion (GAE)
|
Space-occupying or ring-enhancing lesion
|
| Diagnosis
|
CSF wet mount or PCR
|
Cysts in brain biopsy, immunostaining or PCR; trophozoites or cysts on corneal scraping
|
Cysts in brain biopsy, immunostaining or PCR
|
| Treatment
|
Intrathecal and intravenous amphotericin B, azoles, rifampin, miltefosine
|
Pentamidine, azoles, flucytosine, sulfadiazine, miltefosine, amikacin, voriconazole
|
Pentamidine, azithromcin, fluconazole, sulfadiazine, flucytosine, miltefosine
|
