TABLE 3

Selected cases of amoebic meningoencephalitis with successful outcomes

YearPatient descriptionCausative agentTreatment
200033-yr-old manAcanthamoeba spp.Sulfadiazine, pyrimethamine, and fluconazole; left homonymous hemianopia (visual field defects)
200245-yr-old womanAcanthamoeba spp.Rifampin, co-trimoxazole, fluconazole, and ceftriaxone for 4 wk; monitored for 1 yr for facial nerve palsy
200610-yr-old boyAcanthamoeba spp.Ketoconazole and rifampin; duration of therapy is unknown
200825-yr-old manAcanthamoeba spp.Miltefosine; seronegative for Acanthamoeba after treatment but neurological deficits did not improve in monitoring for 24 mo
200963-yr-old man with history of contact with contaminated waterAcanthamoeba spp.Amphotericin B and rifampin; discharged after 78 days of hospitalization
20112-yr-old boy with underlying acute lymphoblastic leukemiaAcanthamoeba spp.Meropenem, teicoplanin, fosfomycin, metronidazole, and liposomal amphotericin B; symptom resolution
2012Immunocompetent 38-yr-old manAcanthamoeba spp.Voriconazole and miltefosine; radiological and clinical relief after 6 days of treatment, with subsequent monitoring for refractory seizure complications
20122-yr-old boyAcanthamoeba spp.Co-trimoxazole, rifampin, and ketoconazole; improvement after 2 days
201430-yr-old manAcanthamoeba spp.Rifampin, sulfamethoxazole-trimethoprim, and fluconazole for 2 wk; asymptomatic after 2 wk of monitoring
20162-yr-old boyAcanthamoeba spp.Ceftazidime, metronidazole, fluconazole, and rifampin for 3 wk
201611-yr-old girlAcanthamoeba spp.Amphotericin B, sulfamethoxazole-trimethoprim, and rifampin
201612-yr-old boyAcanthamoeba spp.Amphotericin B, sulfamethoxazole-trimethoprim, and rifampin
20169-mo-old girlAcanthamoeba spp.Amphotericin B, sulfamethoxazole-trimethoprim, and rifampin
200364-yr-old manBalamuthia mandrillarisAmphotericin B, flucytosine, fluconazole, and sulfadiazine for 5 yr, clarithromycin for 2 yr, and pentamidine for 18 days
20035-yr-old girlBalamuthia mandrillarisFlucytosine and fluconazole for 2 yr, pentamidine for 34 days, and clarithromycin for 2 yr
200472-yr-old womanBalamuthia mandrillarisPentamidine, sulfadiazine, fluconazole, and clarithromycin; hospitalized for 13 days
200472-yr-old manBalamuthia mandrillarisFluconazole, sulfadiazine, clarithromycin, and pentamidine isethionate; duration of therapy is unknown
200610-yr-old girlBalamuthia mandrillarisAlbendazole, itraconazole, and sulfamethoxazole-trimethoprim for 6 mo
20068-yr-old boyBalamuthia mandrillarisAlbendazole and itraconazole for 14 mo
201021-yr-old womanBalamuthia mandrillarisAlbendazole and fluconazole for 7.5 mo and miltefosine for 7 mo
20102-yr-old boyBalamuthia mandrillarisPentamidine (stopped after 2 mo), sulfadiazine, flucytosine, clarithromycin, and fluconazole
201027-yr-old manBalamuthia mandrillarisSulfadiazine, azithromycin, and miltefosine for unspecified duration
201127-yr-old male organ recipientBalamuthia mandrillarisPentamidine, sulfadiazine, flucytosine, fluconazole, azithromycin, and miltefosine
201180-yr-old womanBalamuthia mandrillarisPentamidine, itraconazole, azithromycin, sulfadiazine, flucytosine, and liposomal amphotericin
20135-yr-old girlBalamuthia mandrillarisFlucytosine, fluconazole, azithromycin, pentamidine, and sulfadiazine, changed to final regimen of azithromycin, fluconazole, and miltefosine
20134-yr-old immunocompetent girl with history of water contact from floods around her residenceBalamuthia mandrillarisFlucytosine, fluconazole, azithromycin, pentamidine, and sulfadiazine
200226-yr-old womanNaegleria fowleriRifampin, amphotericin B, and ornidazole for 2 wk
20088-mo-old boyNaegleria fowleriAmphotericin B, chloramphenicol, and rifampin; afebrile at day 7 of treatment
201312-yr-old girl and 8-yr-old boyNaegleria fowleriAmphotericin B, fluconazole, rifampin, azithromycin, dexamethasone, and miltefosine for both