FATAL GRANULOMATOUS AMEBIC ENCEPHALITIS CAUSED BY BALAMUTHIA-MANDRILLARIS

Granulomatous amoebic encephalitis caused by Balamuthia mandrillaris i s rare (63 human cases reported worldwide) and fatal. We report a case in a five-year-old boy who had previously been well. For 18 months, h e had had a slowly progressive, granulomatous mid facial lesion, but d espite extensive investigation definitive diagnosis was made only with the acute onset of neurological signs in the last two weeks of life, when a brain biopsy specimen revealed amoebic trophozoites and cysts. infection with B. mandrillaris should be considered in the differentia l diagnosis of chronic skin lesions with non-specific granulomatous hi stopathology and negative microbiological test results.