Transmission of<i>Balamuthia mandrillaris</i>by Organ Transplantation

Farnon, Eileen C.; Kokko, Kenneth E.; Budge, Philip J.; Mbaeyi, Chukwuma; Lutterloh, Emily; Qvarnström, Yvonne; Silva, Alexandre J. da; Shieh, Wun‐Ju; Roy, Sharon L.; Paddock, Christopher D.; Sriram, Rama; Zaki, Sherif R.; Visvesvara, Govinda S.; Kuehnert, Matthew J.; Weiss, Joli; Komatsu, Ken; Manch, Richard; Ramos, Alberto R.; Echeverria, Leonor; Moore, Ann L.; Zakowski, Phil; Kittleson, M.; Kobashigawa, J.; Yoder, Jonathan S.; Beach, Michael J.; Mahle, William T.; Kanter, Kirk R.; Geraghty, P J; Navarro, E Solera; Hahn, Christine; Fujita, Shiro; Stinson, Jim; Trachtenberg, Joel D.; Byers, Paul; Cheung, Michèle; Jie, Tun; Kaplan, Bruce; Gruessner, R.; Bracamonte, Erica; Viscusi, Chad; González‐Peralta, Regino P.; Lawrence, Robert M.; Fratkin, Jonathan D.; Butt, Fauzia

doi:10.1093/cid/ciw422

Cited by 49 publications

(22 citation statements)

References 31 publications

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“…In 2015, one case that developed GAE after bone marrow transplantation was reported in Japan (Table ), and in the USA, cases of GAE associated with B. mandrillaris and Acanthamoeba spp. and the result of organ transplantation were also reported . GAE is a chronic or subacute disease that causes headaches, fever, fatigue, as well as spasms and limb paresis (Table ).…”

Section: Gaementioning

confidence: 99%

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Pathogenic free‐living amoebic encephalitis in Japan

2019

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Over 600 cases of amoebic encephalitis caused by pathogenic free-living amoebas (Balamuthia mandrillaris, Acanthamoeba spp., and Naegleria fowleri) have been reported worldwide, and in Japan, 24 cases have been reported from the first case in 1976 up to 2018. Among these cases, 18 were caused by B. mandrillaris, four by Acanthamoeba spp., one by N. fowleri, and one was of unknown etiology. Additionally, eight cases were diagnosed with encephalitis due to pathogenic free-living amoebas before death, but only three cases were successfully treated. Unfortunately, all other cases were diagnosed by autopsy. These facts indicate that an adequate diagnosis is difficult, because encephalitis due to pathogenic free-living amoebas does not show typical symptoms or laboratory findings. Moreover, because the number of cases is limited, other cases might have been missed outside of those diagnosed by autopsy. Cases of encephalitis caused by B. mandrillaris have been reported from all over Japan, with B. mandrillaris recently isolated from soil in Aomori prefecture. Therefore, encephalitis caused by pathogenic free-living amoebas should be added to the differential diagnosis of encephalitis patients.

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Section: Gaementioning

confidence: 99%

“…and the result of organ transplantation were also reported. 19,20 GAE is a chronic or subacute disease that causes headaches, fever, fatigue, as well as spasms and limb paresis 1 (Table 1). Recent reports indicated a relationship between GAE and cognitive dysfunction (Table 1) similar to cases of encephalomyelitis caused by archaea.…”

Section: Introductionmentioning

confidence: 99%

Pathogenic free‐living amoebic encephalitis in Japan

2019

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“… B. mandrillaris is thought to be transmitted by inhalation of contaminated aerosols or exposure via broken skin ( 36 ). Fatal amoebic encephalitis has also occurred after solid-organ transplantation ( 37 , 38 ). Pathogenesis is believed to involve hematogenous spread to the CNS through penetration of the blood-brain barrier, and amoebae are frequently observed around blood vessels ( 3 , 36 ).…”

Section: Introductionmentioning

confidence: 99%

Functional Assessment of 2,177 U.S. and International Drugs Identifies the Quinoline Nitroxoline as a Potent Amoebicidal Agent against the Pathogen Balamuthia mandrillaris

Laurie

White

Retallack

et al. 2018

mBio

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Balamuthia mandrillaris is responsible for hundreds of reported cases of amoebic encephalitis, the majority of which have been fatal. Despite being an exceptionally deadly pathogen, B. mandrillaris is understudied, leaving many open questions regarding epidemiology, diagnosis, and treatment. Due to the lack of effective drugs to fight B. mandrillaris infections, mortality rates remain high even for patients receiving intensive care. This report addresses the need for new treatment options through a drug repurposing screen to identify novel B. mandrillaris inhibitors. The most promising candidate identified was the quinoline antibiotic nitroxoline, which has a long history of safe use in humans. We show that nitroxoline kills B. mandrillaris at pharmacologically relevant concentrations and exhibits greater potency and selectivity than drugs commonly used in the current standard of care. The findings that we present demonstrate the potential of nitroxoline to be an important new tool in the treatment of life-threatening B. mandrillaris infections.

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“…The incubation period from exposure to development of clinical symptoms is not well established and experts believe that this may occur between 2 months and 2 years. Finally, an alternative mode of transmission via solid organ transplantation has also gained attention [ 297 – 299 ]. In many cases, GAE is diagnosed post-mortem, due to delayed diagnosis or unawareness of the clinical entity.…”

Section: Bacteriamentioning

confidence: 99%

Emerging Infections and Pertinent Infections Related to Travel for Patients with Primary Immunodeficiencies

et al. 2017

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In today’s global economy and affordable vacation travel, it is increasingly important that visitors to another country and their physician be familiar with emerging infections, infections unique to a specific geographic region, and risks related to the process of travel. This is never more important than for patients with primary immunodeficiency disorders (PIDD). A recent review addressing common causes of fever in travelers provides important information for the general population Thwaites and Day (N Engl J Med 376:548-560, 2017 ). This review covers critical infectious and management concerns specifically related to travel for patients with PIDD. This review will discuss the context of the changing landscape of infections, highlight specific infections of concern, and profile distinct infection phenotypes in patients who are immune compromised. The organization of this review will address the environment driving emerging infections and several concerns unique to patients with PIDD. The first section addresses general considerations, the second section profiles specific infections organized according to mechanism of transmission, and the third section focuses on unique phenotypes and unique susceptibilities in patients with PIDDs. This review does not address most parasitic diseases. Reference tables provide easily accessible information on a broader range of infections than is described in the text.

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Transmission ofBalamuthia mandrillarisby Organ Transplantation

Cited by 49 publications

References 31 publications

Pathogenic free‐living amoebic encephalitis in Japan

Pathogenic free‐living amoebic encephalitis in Japan

Functional Assessment of 2,177 U.S. and International Drugs Identifies the Quinoline Nitroxoline as a Potent Amoebicidal Agent against the Pathogen Balamuthia mandrillaris

Emerging Infections and Pertinent Infections Related to Travel for Patients with Primary Immunodeficiencies

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