The Epidemiology and Clinical Features of Balamuthia mandrillaris Disease in the United States, 1974 – 2016

Details

• Alternative Title:
  Clin Infect Dis
• Personal Author:
  Cope, Jennifer R. ; Landa, Janet ; Nethercut, Hannah ; Collier, Sarah A. ; Glaser, Carol ; Moser, Melanie ; Puttagunta, Raghuveer ; Yoder, Jonathan S. ; Ali, Ibne K. ; Roy, Sharon L.
• Description:
  Background ; Balamuthia mandrillaris is a free-living ameba that causes rare, nearly always fatal disease in humans and animals worldwide. B. mandrillaris has been isolated from soil, dust, and water. Initial entry of Balamuthia into the body is likely via the skin or lungs. To date, only individual case reports and small case series have been published. ; Methods ; The Centers for Disease Control and Prevention (CDC) maintains a free-living ameba (FLA) registry and laboratory. To be entered into the registry, a Balamuthia case must be laboratory-confirmed. Several sources were used to complete entries in the registry, including case report forms, CDC laboratory results, published case reports, and media information. SAS© version 9.3 software was used to calculate descriptive statistics and frequencies. ; Results ; We identified 109 case reports of Balamuthia disease between 1974 and 2016. Most (99%) had encephalitis. The median age was 36 years (range 4 months to 91 years). Males accounted for 68% of the case patients. California had the highest number of case reports followed by Texas and Arizona. Hispanics constituted 55% for those with documented ethnicity. Exposure to soil was commonly reported. Among those with a known outcome, 90% of patients died. ; Conclusions ; Balamuthia disease in the United States is characterized by a highly fatal encephalitis that affects patients of all ages. Hispanics were disproportionately affected. The southwest region of the U.S. reported the most cases. Clinician awareness of Balamuthia as a cause of encephalitis might lead to earlier diagnosis and initiation of treatment, resulting in better outcomes. ; Summary ; We describe 109 case reports of Balamuthia disease in the United States between 1974 and 2016. Most were male with encephalitis, had a median age of 36 years, and were reported from southwestern states. Ninety percent of patients died.
• Subjects:
  • Article
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Amebiasis
  • Central Nervous System Protozoal Infections
  • Child
  • Child, Preschool
  • Female
  More +
• Source:
  Clin Infect Dis. 68(11):1815-1822
• Pubmed ID:
  30239654
• Pubmed Central ID:
  PMC7453664
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHS/United States
• Place as Subject:
  United States
• Volume:
  68
• Issue:
  11
• Download URL:
  https://stacks.cdc.gov/view/cdc/92694/cdc_92694_DS1.pdf
• File Type:
  [PDF - 423.05 KB]
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:db4055865ce322cd705e0949dd98bcc42b5f660f9fe1734a87c3e81012f35252