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首页> 外文期刊>The American Journal of Tropical Medicine and Hygiene >Case Report: Encephalitis Caused by Balamuthia mandrillaris in a 3-Year-Old Iranian Girl
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Case Report: Encephalitis Caused by Balamuthia mandrillaris in a 3-Year-Old Iranian Girl

机译：病例报告：在一个3岁的伊朗女孩的Balamuthia Mandrillaris引起的脑炎

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摘要

It is about half a century since free-living amoebae were recognized as pathogenic organisms, but there is still much we should learn about these rare fatal human infectious agents. A recently introduced causative agent of granulomatous amoebic encephalitis, Balamuthia mandrillaris, has been reported in a limited number of countries around the world. A 3-year-old girl was referred to our tertiary hospital because of inability to establish a proper diagnosis. She had been experiencing neurologic complaints including ataxia, altered level of consciousness, dizziness, seizure, and left sided hemiparesis. The patient's history, physical examination results, and laboratory investigations had led to a wide differential diagnosis. Computed tomography (CT) scan and magnetic resonance imaging analyses revealed multiple mass lesions. As a result, the patient underwent an intraoperative frozen section biopsy of the brain lesion. The frozen section study showed numerous cells with amoeba-like appearances in the background of mixed inflammatory cells. Medications for free-living amoebic meningoencephalitis were administered. PCR assay demonstrated B. mandrillaris as the pathogenic amoeba. Unfortunately, the patient died 14 days after her admission. To our knowledge, this is the first report of B. mandrillaris meningoencephalitis in the Middle East and the first time we have captured the organism during a frozen-section study.
机译：自自由生活的阿米巴被认为是致病性生物体以来，已经过去了大约半个世纪，但对于这些罕见的致命人类传染源，我们仍有很多需要了解的地方。最近引进的肉芽肿性阿米巴脑炎病原体Balamuthia mandrillaris已在世界上少数国家报告。一名3岁女孩因无法确定正确诊断而被转诊到我们的三级医院。她曾经历过神经系统症状，包括共济失调、意识水平改变、头晕、癫痫和左侧偏瘫。患者的病史、体检结果和实验室检查导致了广泛的鉴别诊断。计算机断层扫描（CT）和磁共振成像分析显示多个肿块病变。结果，患者在术中对脑部病变进行了冰冻切片活检。冰冻切片研究显示，在混合炎性细胞背景下，有大量阿米巴样细胞出现。对自由生活的阿米巴脑膜脑炎患者进行药物治疗。PCR检测表明，曼氏杆菌是致病性变形虫。不幸的是，患者在入院14天后死亡。据我们所知，这是在中东第一次报告曼氏杆菌脑膜脑炎，我们第一次在冰冻切片研究中捕捉到了有机体。

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