Challenges and advances in the medical treatment of granulomatous amebic encephalitis

Author:

Spottiswoode Natasha1,Haston Julia C.2,Hanners Natasha W.3,Gruenberg Katherine4ORCID,Kim Annie5,DeRisi Joseph L.67,Wilson Michael R.8ORCID

Affiliation:

1. Division of Infectious Diseases, University of California San Francisco, San Francisco, CA, USA

2. Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA

3. Division of Pediatric Infectious Diseases, University of Texas Southwestern, Dallas, TX, USA

4. Department of Clinical Pharmacy, University of California San Francisco School of Pharmacy, San Francisco, CA, USA

5. Department of Clinical Pharmacy, Zuckerberg San Francisco General, San Francisco, CA, USA

6. Department of Biochemistry and Biophysics, University of California San Francisco, San Francisco, CA, USA

7. Chan Zuckerberg Biohub SF, San Francisco, CA, USA

8. Weill Institute for Neurosciences, Department of Neurology, University of California San Francisco, San Francisco, CA 94143, USA

Abstract

Granulomatous amebic encephalitis, caused by the free-living amebae Balamuthia mandrillaris or Acanthamoeba species, is a rare and deadly infectious syndrome with a current mortality rate of >90%. Much work remains to define the optimal treatment for these infections. Here, we provide a comprehensive overview of the supporting evidence behind antimicrobials currently recommended by the Centers for Disease Control and Prevention (CDC) with updated statistics on survival rates and medication usage from the CDC Free-Living Ameba Database. We also discuss promising treatments, especially the emerging therapeutic agent nitroxoline, and provide recommendations for the next steps in this area.

Funder

Westridge Foundation

Chan Zuckerberg Biohub SF

National Institute of Allergy and Infectious Diseases

Publisher

SAGE Publications

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