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Chapter 139 : Pathogenic and Opportunistic Free-Living Amebae

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Pathogenic and Opportunistic Free-Living Amebae, Page 1 of 2

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Abstract:

Pathogenic and opportunistic free-living amebae, such as spp., , , and , cause devastating central nervous system and disseminated infections in humans, leading to death. A brief review of the types of infections caused, clinical characteristics, pathologic manifestations, morphologic and molecular diagnoses, treatment, and prevention, if any, are discussed.

Citation: Visvesvara G. 2015. Pathogenic and Opportunistic Free-Living Amebae, p 2387-2398. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch139
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Figures

Image of FIGURES 1 through 4
FIGURES 1 through 4

( ) Trophozoite, phase contrast (note the uroid and filaments at the arrow); ( ) trophozoite, trichrome stain; ( ) biflagellate, phase contrast; ( ) smooth-walled cyst, phase contrast (note the pore at the arrow). All magnifications, approximately ×835. doi:10.1128/9781555817381.ch139.f1-4

Citation: Visvesvara G. 2015. Pathogenic and Opportunistic Free-Living Amebae, p 2387-2398. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch139
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Image of FIGURES 5 and 6
FIGURES 5 and 6

. ( ) Trophozoite, phase contrast (note the acanthopodia at the arrow); ( ) double-walled cyst, phase contrast. Both magnifications, approximately ×835. doi:10.1128/9781555817381.ch139.f5-6

Citation: Visvesvara G. 2015. Pathogenic and Opportunistic Free-Living Amebae, p 2387-2398. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch139
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Image of FIGURES 7 and 8
FIGURES 7 and 8

( ) Trophozoite, phase contrast; ( ) cyst, phase contrast. Both magnifications, approximately ×1,140. doi:10.1128/9781555817381.ch139.f7-8

Citation: Visvesvara G. 2015. Pathogenic and Opportunistic Free-Living Amebae, p 2387-2398. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch139
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Image of FIGURE 9
FIGURE 9

Large numbers of trophozoites (arrows) in a section of CNS tissue, showing extensive necrosis and destruction of brain tissue. Magnification, approximately ×564. doi:10.1128/9781555817381.ch139.f9

Citation: Visvesvara G. 2015. Pathogenic and Opportunistic Free-Living Amebae, p 2387-2398. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch139
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Image of FIGURE 10
FIGURE 10

trophozoites (arrows) and a cyst (arrowhead) around a blood vessel in a section of CNS tissue from a GAE patient. Magnification, approximately ×489. doi:10.1128/9781555817381.ch139.f10

Citation: Visvesvara G. 2015. Pathogenic and Opportunistic Free-Living Amebae, p 2387-2398. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch139
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Image of FIGURE 11
FIGURE 11

trophozoites and a cyst (arrowhead) in a brain section from a GAE patient. Note the double (small arrow) and triple (large arrow) nucleolar elements within the nuclei of the trophozoites. Magnification, approximately ×413. doi:10.1128/9781555817381.ch139.f11

Citation: Visvesvara G. 2015. Pathogenic and Opportunistic Free-Living Amebae, p 2387-2398. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch139
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Image of FIGURE 12
FIGURE 12

Immunofluorescence localization of in a brain section from a GAE patient. Note the fluorescent amebae (arrows) around blood vessels. Magnification, approximately ×188. doi:10.1128/9781555817381.ch139.f12

Citation: Visvesvara G. 2015. Pathogenic and Opportunistic Free-Living Amebae, p 2387-2398. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch139
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References

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1. Aichelberg AC,, Walochnik J,, Assadian O,, Steuer A,, Perneczky G,, Visvesvara GS,, Aspock H,, Vetter N. 2008. Successful treatment of disseminated Acanthamoeba infection and granulomatous amoebic encephalitis in an immunocompromised patient with military tuberculosis and tuberculous meningitis with miltefosine, an alkylphosphocholine. Emerg Infect Dis 14:17431746.
2. Berete S,, Combes A,, de Jonckheere JF,, Datry A,, Varnous S,, Martinez V,, Ptacek SG,, Caumes E,, Capron F,, Francès C,, Gilbert C,, Chosidow O. 2007. Fatal disseminated Acanthamoeba lenticulata infection in a heart transplant patient. Emerg Infect Dis 13:736738.
3. Butt CG. 1966. Primary amebic meningoencephalitis. N Engl J Med 274:14731476.
4. Centers for Disease Control and Prevention. 2010. Balamuthia mandrillaris transmitted through organ transplantation—Mississippi, 2009. MMWR Morb Mortal Wkly Rep 59:11651170.
5. Centers for Disease Control and Prevention. 2010. Notes from the field: transplant transmitted Balamuthia mandrillaris—Arizona, 2010. MMWR Morb Mortal Wkly Rep 59:11829.
6. Cogo PE,, Scaglia M,, Gatti S,, Rossetti F,, Alaggio R,, Laverda AM,, Zhou L,, Xiao L,, Visvesvara GS. 2004. Fatal Naegleria fowleri meningoencephalitis, Italy. Emerg Infect Dis 10:18351837.
7. D’Auria A,, Lin J,, Geiseler P,, Gene K,, Qvarnstrom Y,, Bandea R,, Roy SL,, Sriram R,, Paddock C,, Zaki SR,, Visvesvara GS. 2012. Cutaneous acanthamoebiasis post-transplantation: implication for differential diagnosis of skin lesions in immunocompromised patients. J Neuroparasitol 3:113. 10.4303/jnp/N120801.
8. Deetz TR,, Sawyer MH,, Billman G,, Schuster FL,, Visvesvara GS. 2003. Successful treatment of Balamuthia amebic encephalitis: presentation of two cases. Clin Infect Dis 37: 13041312.
9. Satlin MJ,, Graham JK,, Visvesvara GS,, Mena H,, Marks KM,, Saal SD,, Soave R. 2013. Fulminant and fatal encephalitis caused by Acanthamoeba in a kidney transplant recipient: case report and literature review. Transpl Infect Dis 15:619626.
10. Foreman O,, Sykes J,, Ball L,, Yang N,, De Cock H. 2004. Disseminated infection with Balamuthia mandrillaris in a dog. Vet Pathol 41:506510.
11. Jung S,, Schelper RL,, Visvesvara GS,, Chang HT. 2004. Balamuthia mandrillaris meningoencephalitis in an immunocompetent patient: a case of unusual clinical course and successful outcome. Arch Pathol Lab Med 128:466468.
12. Kaul DR,, Lowe L,, Visvesvara GS,, Farmen S,, Khaled YA,, Yanik GA. 2008. Acanthamoeba infection in a patient with chronic graft-versus-host disease occurring during treatment with voriconazole. Transpl Infect Dis 10:437441.
13. Kemble SK,, Lynfield R,, Devries AS,, Drehner D,, Pompuitus WF,, Beach MJ,, Visvesvara GS,, Da Silva AJ,, Hill VR,, Yoder JS,, Xiao L,, Smith KE,, Danila R. 2012. Fatal Naegleria fowleri infection acquired in Minnesota: possible expanded range of a delay thermophilic organism. Clin Infect Dis 4:805809.
14. Kramer MH,, Lerner CJ,, Visvesvara GS. 1997. Kidney and liver transplants from a donor infected with Naegleria fowleri. J Clin Microbiol 35:10321033.
15. Roy SL,, Metzger R,, Chen JG,, Laham FR,, Martin M,, Kippeer SW,, Smith LE,, Lyon GMIII,, Haffner J,, Ross JE,, Rye AK,, Johnson W,, Bodager D,, Friedman M,, Walsh DJ,, Collins C,, Inman B,, Davis BJ,, Robinson T,, Paddock C,, Zaki SR,, Kehnert M,, DaSilva A,, Qvarnstrom Y,, Sriram R,, Visvesvara GS. 2014. Risk of transmission of Naegleria fowleri from solid organ transplantation. Am J Transpl 14:163171.
16. Lozano-Alarcon F,, Bradley GA,, Houser BS,, Visvesvara GS. 1997. Primary amebic meningoencephalitis due to Naegleria fowleri in a South American tapir. Vet Pathol 34:239243.
17. Marciano-Cabral F,, Cabral G. 2003. The importance of Acanthamoeba spp. as agents of disease in humans. Clin Microbiol Rev 16:273307.
18. Martinez AJ. 1982. Acanthamoebiasis and immunosuppression. Case report. J Neuropathol Exp Neurol 41:548557.
19. Martinez AJ,, Visvesvara GS. 1997. Free-living, amphizoic and opportunistic amebas. Brain Pathol 7:583589.
20. Martinez AJ,, Visvesvara GS. 2001. Balamuthia mandrillaris infection. J Med Microbiol 50:205207.
21. Martinez SM,, Gonzales-Madiero G,, Santiago P,, DeLope AR,, Diz J,, Conde C,, Visvesvara GS. 2000. Granulomatous amebic encephalitis in a patient with AIDS: isolation of Acanthamoeba sp. group II from brain tissue and successful treatment with sulfadiazine and fluconazole. J Clin Microbiol 38:38923895.
22. Visvesvara GS,. 2014. Pathogenic and opportunistic free-living amoebae: agents of human and animal disease, p 683691. In Farrar J,, Hotez PJ,, Junghanss T,, Kang G,, Lalloo D,, White NJ (ed), Manson’s Tropical Diseases, 23rd ed. Elsevier Saunders, Philadelphia, PA.
23. Rideout BA,, Gardiner CH,, Stalis LH,, Zuba JR,, Hadfield T,, Visvesvara GS. 1997. Fatal infections with Balamuthia mandrillaris (a free-living amoeba) in gorillas and other Old World primates. Vet Pathol 34:1522.
24. Shakoor S,, Beg MA,, Mahmood SF,, Bandea R,, Sriram R,, Noman F,, Ali F,, Visvesvara GS,, Zafar A. 2011. Primary amebic meningoencephalitis caused by Naegleria fowleri, Karachi, Pakistan. Emerg Infect Dis 17:258261.
25. Shirwadkar CG,, Samant R,, Sankhe M,, Deshpande R,, Yagi S,, Schuster FL,, Sriram R,, GS Visvesvara. 2006. Acanthamoeba encephalitis in patient with systemic lupus, India. Emerg Infect Dis 12:984986.
26. Schuster FL,, Yagi S,, Gavali S,, Michelson D,, Raghavan R,, Blomquist L,, Glastonbury C,, Bollen AW,, Scharnhorst D,, Reedl SL,, Kuriyama S,, Visvesvara GS,, Gglaser CA. 2009. Under the radar: Balamuthia amebic encephalitis. Clin Infect Dis 7:879887.
27. Schuster FL,, Visvesvara GS. 2004. Free-living amoebae as opportunistic and non-opportunistic pathogens of humans and animals. Int J Parasitol 34:10011027.
28. Seidel JS,, Harmatz P,, Visvesvara GS,, Cohen A,, Edwards J,, Turner J. 1982. Successful treatment of primary amebic meningoencephalitis. N Engl J Med 306:346348.
29. Tavares M,, Correia da Costa JM,, Carpenter S,, Santos LA,, Afonso C,, Aguiar A,, Pereira J,, Cardoso AL,, Schuster FL,, Yagi S,, Sriram R,, Visvesvara GS. 2006. Diagnosis of first case of Balamuthia amoebic encephalitis in Portugal by immunofluorescence and PCR. J Clin Microbiol 44:26602663.
30. Slater CA,, Sickel JZ,, Visvesvara GS,, Pabico RC,, Gaspari AA. 1994. Successful treatment of disseminated Acanthamoeba infection in an immunocompromised patient. N Engl J Med 331:8587.
31. Visvesvara GS,, De Jonckheere JF,, Sriram R,, Daft B. 2005. Isolation and molecular typing of Naegleria fowleri from the brain of a cow that died of primary amebic meningoencephalitis. J Clin Microbiol 43:42034204.
32. Visvesvara GS,, Martinez AJ,, Schuster FL,, Leitch GJ,, Wallace S,, Sawyer TK,, Anderson M. 1990. Leptomyxid ameba, a new agent of amebic meningoencephalitis in humans and animals. J Clin Microbiol 28:27502756.
33. Visvesvara GS,, Schuster FL,, Martinez AJ. 1993. Balamuthia mandrillaris, new genus, new species, agent of amebic meningoencephalitis in humans and animals. J Eukaryot Microbiol 40:504514.
34. Visvesvara GS,, Moura H,, Schuster FL. 2007. Pathogenic and opportunistic free-living amoebae: Acanthamoeba spp., Balamuthia mandrillaris, Naegleria fowleri, and Sappinia diploidea. FEMS Immunol Microbiol 50:126.
35. Webster D,, Umar L,, Kolyvas G,, Bilbao J,, Guiot MC,, Duplisea K,, Qvarnstrom Y,, Visvesvara GS. 2012. Treatment of granulomatous amoebic encephalitis with voriconazole and miltefosine in an immunocompetent soldier. Am J Trop Med Hyg 87:715718.
36. Yoder JS,, Eddy BA,, Visvesvara GS,, Capwell L,, Beach MJ. 2010. The epidemiology of primary amoebic meningoencephalitis, 1962–2008. Epidemiol Infect 138:968975.
37. Yoder JS,, Straif-Bourgeois S,, Roy SL,, Moore TA,, Visvesvara GS,, Ratard RC,, Hill VR,, Wilson JD,, Linscott AJ,, Crager R,, Kozak NA,, Sriram R,, Narayanan J,, Mull B,, Kahler AM,, Schneeberger C,, Da Silva AJ,, Beach MJ. 2012. Primary amebic meningoencephalitis deaths associated with sinus irrigation using contaminated tap water. Clin Infect Dis 55(9):e79e85. 10.1093/cid/cis626.
38. Brasseur G,, Favennec L,, Perrine D,, Chenu JP,, Brasseur P. 1994. Successful treatment of Acanthamoeba keratitis by hexamidine. Cornea 13:459462.
39. Clarke DW,, Niederkorn JY. 2006. The pathophysiology of Acanthamoeba keratitis. Trends Parasitol 22:175180.
40. Jones DB,, Visvesvara GS,, Robinson NM. 1975. Acanthamoeba polyphaga keratitis and Acanthamoeba uveitis associated with fatal meningoencephalitis. Trans Ophthalmol Soc U K 95:221232.
41. Larkin DFP,, Kilvington S,, Dart JKG. 1992. Treatment of Acanthamoeba keratitis with polyhexamethylene biguanide. Ophthalmology 99:185191.
42. Pfister DR,, Cameron JD,, Krachmer JH,, Holland EJ. 1996. Confocal microscopy findings of Acanthamoeba keratitis. Am J Ophthalmol 121:119128.
43. Stehr-Green JK,, Bailey TM,, Visvesvara GS. 1990. The epidemiology of Acanthamoeba keratitis in the United States. Am J Ophthalmol 107:331336.
44. Verani JR,, Lorick SA,, Yoder JS,, Beach MJ,, Braden CR,, Roberts JM,, Conover CS,, Chen S,, McConnell KA,, Chang DC,, Park BJ,, Jones DB,, Visvesvara GS,, Roy SL. 2009. National outbreak of Acanthamoeba keratitis associated with use of contact lens solution, United States. Emerg Infect Dis 15:12361242.
45. Bravo FG,, Cabrera J,, Gottuzo E,, Visvesvara GS,. 2005. Cutaneous manifestations of infection by free-living amebas, p 4955. In Tyring SK,, Lupi O,, Hengge UR (ed), Tropical Dermatology. Elsevier Churchill Livingstone, Philadelphia, PA.
46. Gelman BB,, Rauf SJ,, Nader R,, Popov V,, Borkowski J,, Chaljub G,, Nauta HW,, Visvesvara GS. 2001. Amoebic encephalitis due to Sappinia diploidea. JAMA 285:24502451.
47. Qvarnstrom Y,, Da Silva AJ,, Schuster FL,, Gelman BB,, Visvesvara GS. 2009. Molecular confirmation of Sappinia pedata as causative agent of amebic encephalitis. J Infect Dis 199:11391142.
48. Visvesvara GS,, Sriram R,, Qvarnstrom Y,, Bandyopadhyay K,, Da Silva AJ,, Pieniazek NJ,, Cabral GA. 2009. Paravahlkampfia francinae n. sp. masquerading as an agent of primary amoebic meningoencephalitis. J Eukaryot Microbiol 56:357366.
49. Culbertson CG,, Smith JW,, Minner JR. 1958. Acanthamoeba: observations on animal pathogenicity. Science 127:1506.
50. Carter RF. 1972. Primary amoebic meningoencephalitis. An appraisal of present knowledge. Trans R Soc Trop Med Hyg 66:193208.
51. Adl S,, Simpson AGB,, Farmer MA,, Andersen RA,, Anderson OR,, Barta JR,, Bowser SS,, Brugerolle G,, Fensome RA,, Fredericq S,, James TY,, Karpov S,, Kugrens P,, Krug J,, Lane CE,, Lewis LA,, Lodge J,, Lynn DH,, Mann DG,, McCourt RM,, Mendoza L,, Moestrup O,, Mozley-Standridge SE,, Nerad TA,, Shearer CA,, Smirnov AV,, Spiegel FW,, Taylor MF. 2005. The new higher level classification of eukaryotes with emphasis on the taxonomy of protists. J Eukaryot Microbiol 52:399451.
52. Page FC. 1985. A New Key to Fresh Water and Soil Gymnamoebae. Freshwater Biological Association, Ambleside, Cumbria, England.
53. Sriram R,, Shoff M,, Booton GC,, Fuerst PA,, Visvesvara GS. 2008. Survival of Acanthamoeba cysts after desiccation for more than 20 years. J Clin Microbiol 46:40454048.
54. Booton GC,, Visvesvara GS,, Byers TJ,, Kelly DJ,, Fuerst PA. 2005. Identification and distribution of Acanthamoeba species genotypes associated with nonkeratitis infections. J Clin Microbiol 43:16891693.
55. Qvarnstrom Y,, Nerad TR,, Visvesvara GS. 2013. Characterization of a new pathogenic Acanthamoeba species, A. byersi n. sp., isolated from a human with fatal amoebic encephalitis. J Eukaryot Microbiol 60:626633
56. Stothard DR,, Schroeder-Diedrich JM,, Awwad MH,, Gast RJ,, Ledee DR,, Rodriguez-Zaragoza DS,, Dean CL,, Fuerst PA,, Byers TJ. 1998. The evolutionary history of the genus Acanthamoeba and the identification of eight new 18S rRNA gene sequence types. J Eukaryot Microbiol 45:4554.
57. Fritsche TR,, Horn M,, Wagner M,, Herwig RP,, Schleifer KH,, Gautom RK. 2000. Phylogenetic diversity among geographically dispersed Chlamydiales endosymbionts from clinical and environmental isolates of Acanthamoeba spp. Appl Environ Microbiol 66:26132619.
58. Greub G,, Raoult D. 2004. Microorganisms resistant to free-living amoebae. Clin Microbiol Rev 17:413433.
59. Rowbotham TJ. 1998. Isolation of Legionella pneumophila serogroup 1 from human feces with use of amebic cultures. Clin Infect Dis 26:502503.
60. La Scola B,, Mezi L,, Weiller PJ,, Raoult D. 2001. Isolation of Legionella anisa using an amoebic coculture procedure. J Clin Microbiol 39:365366.
61. Adékambi T,, Reynaud-Gaubert M,, Greub G,, Gevaudan MJ,, La Scola B,, Raoult D,, Drancourt M. 2004. Amoebal coculture of “Mycobacterium massiliense” sp. nov. from the sputum of a patient with hemoptoic pneumonia. J Clin Microbiol 42:54935501.
62. Dunnebacke TH,, Schuster FL,, Yagi S,, Booton GC. 2004. Balamuthia mandrillaris from soil samples. Microbiology 150: 28372842.
63. Niyyati M,, Lorenzo-Morales J,, Rezaeian M,, MartinNavarro CM,, Haghi AM,, Maciver SK,, Valladares B. 2009. Isolation of Balamuthia mandrillaris from urban dust, free of known infectious involvement. Parasitol Res 106:279281.
64. Schuster FL,, Dunnebacke TH,, Booton GC,, Yagi S,, Kohlmeier CK,, Glaser C,, Vugia D,, Bakardjiev A,, Azimi P,, Maddux-Gonzalez M,, Martinez AJ,, Visvesvara GS. 2003. Environmental isolation of Balamuthia mandrillaris associated with a case of amebic encephalitis. J Clin Microbiol 41:31753180.
65. Ahmad AF,, Andrew PW,, Kilvington S. 2011. Development of a nested PCR for environmental detection of the pathogenic free-living amoeba Balamuthia mandrillaris. J Eukaryot Microbiol 58:269271.
66. Tapia JL,, Torres BN,, Visvesvara GS. 2013. Balamuthia mandrillaris: in vitro interactions with selected protozoa and algae. J Eukaryot Microbiol 60:448454.
67. Marciano-Cabral F,, Cabral G. 2007. The immune response to Naegleria fowleri amebae and pathogenesis of infection. FEMS Immunol Med Microbiol 51:243259.
68. Schuster FL,, Glaser C,, Honarmand S,, Maguire JH,, Visvesvara GS. 2004. Balamuthia amebic encephalitis risk, Hispanic Americans. Emerg Infect Dis 10:15101512.
69. Guarner J,, Bartlett J,, Shieh WJ,, Visvesvara GS,, Zaki SR. 2007. Histopathologic spectrum and immunohistochemical diagnosis of amebic meningoencephalitis. Mod Pathol 20:12301237.
70. Johnston SP,, Sriram R,, Qvarnstrom Y,, Roy SL,, Verani J,, Yoder JS,, Lorick S,, Roberts J,, Beach MJ,, Visvesvara GS. 2009. Resistance of Acanthamoeba cysts to disinfection in multiple contact lens solutions. J Clin Microbiol 47: 20402045.
71. Qvarnstrom Y,, Visvesvara GS,, Sriram R,, da Silva AJ. 2006. Multiplex real-time PCR assay for simultaneous detection of Acanthamoeba spp., Balamuthia mandrillaris, and Naegleria fowleri. J Clin Microbiol 44:35893595.
72. Booton GC,, Carmichael JR,, Visvesvara GS,, Byers TJ,, Fuerst PA. 2003. Identification of Balamuthia mandrillaris by PCR assay using the mitochondrial 16S rRNA gene as a target. J Clin Microbiol 41:453455.
73. Yagi S,, Booton GC,, Visvesvara GS,, Schuster FL. 2005. Detection of mitochondrial 16S ribosomal DNA in clinical specimens by PCR. J Clin Microbiol 43:31923197.
74. De Jonckheere JF. 2011. Origin and evolution of the worldwide distributed pathogenic ameboflagellate Naegleria fowleri. Infect Genet Evol 11:15201528.
75. Zhou L,, Sriram R,, Visvesvara GS,, Xiao L. 2003. Genetic variations in the internal transcribed spacer and mitochondrial small subunit rRNA gene of Naegleria spp. J Eukaryot Microbiol 50:522526.
76. Herman EK,, Greninger AL,, Visvesvara GS,, Marciano-Cabral F,, Dacks JB,, Chiu CY. 2013. The mitochondrial genome and a 60Kb nuclear DNA segment from Naegleria fowleri, the causative agent of primary amoebic meningoencephalitis. J Eukaryot Microbiol 60:179191.
77. Jayasekera S,, Sissons J,, Tucker J,, Rogers C,, Nolder D,, Warhurst D,, Alsam S,, White JML,, Higgins EM,, Khan NA. 2004. Post-mortem culture of Balamuthia mandrillaris from the brain and cerebrospinal fluid of a case of granulomatous amoebic meningoencephalitis, using human brain microvascular endothelial cells. J Med Microbiol 53:10071012.
78. Schuster FL. 2002. Cultivation of pathogenic and opportunistic free-living amebas. Clin Microbiol Rev 15:342354.
79. Schuster FL,, Guglielmo JB,, Visvesvara GS. 2006. In-vitro activity of miltefosine and voriconazole on clinical isolates of free-living amebas: Balamuthia mandrillaris, Acanthamoeba spp., and Naegleria fowleri. J Eukaryot Microbiol 53:121126.
80. Schuster FL,, Visvesvara GS. 1996. Axenic growth and drug sensitivity studies of Balamuthia mandrillaris, an agent of amebic meningoencephalitis in humans and other animals. J Clin Microbiol 34:385388.
81. Schuster FL, Honarmand S,, Visvesvara GS,, Glaser CA. 2006. Detection of antibodies against free-living amebae Balamuthia mandrillaris and Acanthamoeba spp. in a population of encephalitis patients. Clin Infect Dis 42:12601265.
82. Kucerova Z,, Sriram R,, Wilkins PP,, Visvesvara GS. 2011. Identification of antigenic targets for immunodetection of Balamuthia mandrillaris infection. Clin Vaccine Immunol 18:12971301.
83. Martínez DY,, Seas C,, Bravo F,, Legua P,, Ramos C,, Cabello AM,, Gotuzzo E. 2010. Successful treatment of Balamuthia mandrillaris amoebic infection with extensive neurological and cutaneous involvement. Clin Infect Dis 51:e7e11. 10.1086/653609.
84. Linum WM,, Ahmad M,, Cope JR,, Chu C,, Visvesvara GS,, da Silva AJ,, Qvarnstrom Y,, Green J. 2015. Successful treatment of an adolescent with Naegleria fowleri primary meningoencephalitis. Pediatrics 135:e744748.

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