Amoebiasis: Neurological involvement and neurobiology

Abstract

Granulomatous amoebic encephalitis (GAE) is a rare and severe human disease leading almost always to death. It is caused by two protist pathogens, Acanthamoeba and Balamuthia mandrillaris. Early diagnosis, followed by aggressive treatment using a combination of drugs is a pre-requisite in successful treatment, but even then the prognosis remains poor (>90 % case fatality rate). Existing drugs have limitations due to a high degree of toxicity and deleterious side effects. In addition, a major concern during the course of treatment is the ability of amoebae to transform into dormant cyst forms, which may provide resistance to drugs and allow amoebae to reactivate following completion of drug therapy, resulting in recurrence of the infection. A complete understanding of the disease, clinical symptoms, available diagnostic methods, possible therapeutic interventions and knowledge of the causative agent would undoubtedly augment our ability to counter this deadly infection.