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Pérez-Pérez P, Artigas P, Reyes-Batlle M, Córdoba-Lanús E, Rodríguez-Expósito RL, Cuervo PF, Domínguez-de-Barros A, García-Pérez O, Valero MA, De Elías A, Anglés R, Mas-Coma S, Piñero JE, Bargues MD, Lorenzo-Morales J. Potentially pathogenic free-living amoebae at very high altitude: Detection by multiplex qPCR in the Northern Altiplano fascioliasis hyperendemic area in Bolivia. One Health 2025; 20:100985. [PMID: 40035019 PMCID: PMC11874821 DOI: 10.1016/j.onehlt.2025.100985] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2024] [Revised: 01/30/2025] [Accepted: 02/01/2025] [Indexed: 03/05/2025] Open
Abstract
Free-living amoebae (FLA), which are frequently found in the environment, include opportunistic pathogenic genera/species such as Acanthamoeba spp., Balamuthia mandrillaris, Naegleria fowleri and Vermamoeba vermiformis. These pathogenic FLA are causative agents of amoebic encephalitis and keratitis in the case of Acanthamoeba genus and V. vermiformis. In addition, amoebic infections are often related to contamination of domestic and recreational water sources. This study aimed to identify potentially pathogenic FLA in the hyperendemic area of human fascioliasis in a very-high-altitude area (3800-4100 m a.s.l.) of Bolivia and examine whether an association between both pathogens could be established from the environmental point of view. A total of 55 samples (28 soil and 27 water samples) were collected from various locations in the Northern Altiplano of Bolivia. Samples were processed by multiplex qPCR to detect the four pathogenic FLA genera/species. All samples were positive for the presence of V. vermiformis, followed by Acanthamoeba spp. which was positive in 18 soil and 10 water samples. In contrast, B. mandrillaris was only detected in soil sources, whereas N. fowleri was not detected in any of the samples. The coexistence and diverse distribution of multiple FLA species in many locations at such a high altitude is worth mentioning and indicates a potential risk of coinfections. These findings suggest that FLA surveillance is a crucial factor to be considered when implementing preventive measures and improving public health in fascioliasis hyperendemic areas.
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Affiliation(s)
- Patricia Pérez-Pérez
- Instituto Universitario de Enfermedades Tropicales y Salud Pública de Canarias (IUETSPC), Universidad de La Laguna (ULL), San Cristóbal de La Laguna, Spain
- Departamento de Obstetricia y Ginecología, Pediatría, Medicina Preventiva y Salud Pública, Toxicología, Medicina Legal y Forense y Parasitología, Universidad de La Laguna, San Cristóbal de La Laguna, Spain
| | - Patricio Artigas
- CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, C/ Monforte de Lemos 3-5. Pabellón 11. Planta 0, 28029 Madrid, Spain
- Departamento de Parasitología, Facultad de Farmacia, Universidad de Valencia, Av. Vicent Andrés Estellés s/n, 46100 Burjassot, Valencia, Spain
| | - María Reyes-Batlle
- Instituto Universitario de Enfermedades Tropicales y Salud Pública de Canarias (IUETSPC), Universidad de La Laguna (ULL), San Cristóbal de La Laguna, Spain
- Departamento de Obstetricia y Ginecología, Pediatría, Medicina Preventiva y Salud Pública, Toxicología, Medicina Legal y Forense y Parasitología, Universidad de La Laguna, San Cristóbal de La Laguna, Spain
- CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, C/ Monforte de Lemos 3-5. Pabellón 11. Planta 0, 28029 Madrid, Spain
| | - Elizabeth Córdoba-Lanús
- Instituto Universitario de Enfermedades Tropicales y Salud Pública de Canarias (IUETSPC), Universidad de La Laguna (ULL), San Cristóbal de La Laguna, Spain
- CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, C/ Monforte de Lemos 3-5. Pabellón 11. Planta 0, 28029 Madrid, Spain
| | - Rubén L. Rodríguez-Expósito
- Instituto Universitario de Enfermedades Tropicales y Salud Pública de Canarias (IUETSPC), Universidad de La Laguna (ULL), San Cristóbal de La Laguna, Spain
- Departamento de Obstetricia y Ginecología, Pediatría, Medicina Preventiva y Salud Pública, Toxicología, Medicina Legal y Forense y Parasitología, Universidad de La Laguna, San Cristóbal de La Laguna, Spain
- CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, C/ Monforte de Lemos 3-5. Pabellón 11. Planta 0, 28029 Madrid, Spain
| | - Pablo F. Cuervo
- CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, C/ Monforte de Lemos 3-5. Pabellón 11. Planta 0, 28029 Madrid, Spain
- Departamento de Parasitología, Facultad de Farmacia, Universidad de Valencia, Av. Vicent Andrés Estellés s/n, 46100 Burjassot, Valencia, Spain
| | - Angélica Domínguez-de-Barros
- Instituto Universitario de Enfermedades Tropicales y Salud Pública de Canarias (IUETSPC), Universidad de La Laguna (ULL), San Cristóbal de La Laguna, Spain
| | - Omar García-Pérez
- Instituto Universitario de Enfermedades Tropicales y Salud Pública de Canarias (IUETSPC), Universidad de La Laguna (ULL), San Cristóbal de La Laguna, Spain
| | - M. Adela Valero
- CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, C/ Monforte de Lemos 3-5. Pabellón 11. Planta 0, 28029 Madrid, Spain
- Departamento de Parasitología, Facultad de Farmacia, Universidad de Valencia, Av. Vicent Andrés Estellés s/n, 46100 Burjassot, Valencia, Spain
| | - Alejandra De Elías
- CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, C/ Monforte de Lemos 3-5. Pabellón 11. Planta 0, 28029 Madrid, Spain
- Departamento de Parasitología, Facultad de Farmacia, Universidad de Valencia, Av. Vicent Andrés Estellés s/n, 46100 Burjassot, Valencia, Spain
| | - René Anglés
- Cátedra de Parasitología, Facultad de Medicina, Universidad Mayor de San Andrés (UMSA), Av. Saavedra, Miraflores, La Paz, Bolivia
| | - Santiago Mas-Coma
- CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, C/ Monforte de Lemos 3-5. Pabellón 11. Planta 0, 28029 Madrid, Spain
- Departamento de Parasitología, Facultad de Farmacia, Universidad de Valencia, Av. Vicent Andrés Estellés s/n, 46100 Burjassot, Valencia, Spain
| | - José E. Piñero
- Instituto Universitario de Enfermedades Tropicales y Salud Pública de Canarias (IUETSPC), Universidad de La Laguna (ULL), San Cristóbal de La Laguna, Spain
- Departamento de Obstetricia y Ginecología, Pediatría, Medicina Preventiva y Salud Pública, Toxicología, Medicina Legal y Forense y Parasitología, Universidad de La Laguna, San Cristóbal de La Laguna, Spain
- CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, C/ Monforte de Lemos 3-5. Pabellón 11. Planta 0, 28029 Madrid, Spain
| | - M. Dolores Bargues
- CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, C/ Monforte de Lemos 3-5. Pabellón 11. Planta 0, 28029 Madrid, Spain
- Departamento de Parasitología, Facultad de Farmacia, Universidad de Valencia, Av. Vicent Andrés Estellés s/n, 46100 Burjassot, Valencia, Spain
| | - Jacob Lorenzo-Morales
- Instituto Universitario de Enfermedades Tropicales y Salud Pública de Canarias (IUETSPC), Universidad de La Laguna (ULL), San Cristóbal de La Laguna, Spain
- Departamento de Obstetricia y Ginecología, Pediatría, Medicina Preventiva y Salud Pública, Toxicología, Medicina Legal y Forense y Parasitología, Universidad de La Laguna, San Cristóbal de La Laguna, Spain
- CIBER de Enfermedades Infecciosas, Instituto de Salud Carlos III, C/ Monforte de Lemos 3-5. Pabellón 11. Planta 0, 28029 Madrid, Spain
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Ravindran B, Hennessy D, O'Hara M, Tay EL, Banuve RS, McVernon J, Carville K. Epidemiology of Buruli Ulcer in Victoria, Australia, 2017-2022. Emerg Infect Dis 2025; 31:448-457. [PMID: 40023793 PMCID: PMC11878321 DOI: 10.3201/eid3103.240938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2025] Open
Abstract
Buruli ulcer (BU) is a rare, neglected tropical disease caused by Mycobacterium ulcerans that can lead to severe skin ulcers. To determine the epidemiology of BU in Victoria, Australia, during 2017-2022 we analyzed surveillance data. A total of 1,751 cases of BU were notified; 968 (55%) patients were male and 781 (45%) female (2 were missing sex data), and 984 (56%) resided in established BU-endemic areas, although an increasing number were in new BU-endemic areas. Most cases (83%, 1,301) were classified as category I. Multivariate modeling demonstrated that factors for severe BU included being male, being older, and living in a new BU-endemic or non-BU-endemic area. A relatively shorter interval between first visit to a clinician and receipt of diagnosis was protective against severe disease. The expansion of BU-endemic areas throughout Victoria remains a public health concern and calls for targeted action, particularly for patients and clinicians in new BU-endemic areas.
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Xu H, Wang D, Cui K, Wan R, Chi Q, Wu T. 18F-FDG PET/CT findings in fatal Balamuthia Mandrillaris encephalitis in brain stem: A case report. Radiol Case Rep 2024; 19:1851-1854. [PMID: 38425772 PMCID: PMC10901688 DOI: 10.1016/j.radcr.2024.02.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 02/03/2024] [Accepted: 02/06/2024] [Indexed: 03/02/2024] Open
Abstract
We presented a case of a 66-year-old female whose initial symptom was headache without obvious inducement. The patient's condition progressed rapidly to a semi-coma state after symptomatic treatment. The 18F-FDG PET/CT scan revealed circular FDG hypermetabolism and central metabolic defect of the pons and left frontal lobe lesions. The combination of clinical findings, MRI, and Metagenomic next-generation sequencing (NGS) of cerebrospinal fluid led to the diagnosis of Balamuthia mandrillaris encephalitis. The patient died 5 days after discharge.
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Affiliation(s)
- Hualei Xu
- Department of Nuclear Medicine, Taihe County People's Hospital, Taihe, China
| | - Dawei Wang
- Department of Nuclear Medicine, Taihe County People's Hospital, Taihe, China
| | - Kunwei Cui
- Department of Laboratory Medicine, the First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Ruimei Wan
- Department of Nuclear Medicine, Taihe County People's Hospital, Taihe, China
| | - Quan Chi
- Department of Nuclear Medicine, Taihe County People's Hospital, Taihe, China
| | - Tao Wu
- Department of Nuclear Medicine, the First Affiliated Hospital of Anhui Medical University, Hefei, China
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Zhang Z, Liang J, Wei R, Feng X, Wang L, Wang L, Zhao P, Yu H, Gu Y, Yao Z. Facial Balamuthia mandrillaris infection with neurological involvement in an immunocompetent child. THE LANCET. INFECTIOUS DISEASES 2022; 22:e93-e100. [PMID: 34838200 DOI: 10.1016/s1473-3099(21)00334-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 05/14/2021] [Accepted: 05/26/2021] [Indexed: 06/13/2023]
Abstract
Cutaneous infection by Balamuthia mandrillaris is a rare condition that is sometimes complicated by life-threatening CNS involvement. It often evades timely diagnosis due to its rarity and non-specific clinical manifestations. Patients can be either immunocompetent or immunocompromised. It is probably transmitted via inhalation or inoculation through broken skin, and then spreads to the brain and other organs through haematogenous spread. It is important for clinicians to be aware of this disease because rapid diagnosis and subsequent therapy has, in some cases, been associated with survival. In this Grand Round, we report the case of a 7-year-old boy who presented with large, chronic plaques on his face. Several biopsies showed non-specific granulomatous inflammation. The patient deteriorated rapidly and died within 1 month of displaying abnormal symptoms in the CNS. Immunohistochemical staining of skin tissue identified B mandrillaris as the infectious agent. The diagnosis was confirmed with PCR, which detected B mandrillaris DNA in formalin-fixed skin tissue sections. B mandrillaris infection should be considered in the differential diagnosis of patients with chronic granulomatous lesions. We also reviewed the epidemiology, B mandrillaris in nature and in the laboratory, clinical manifestations, histopathology, diagnosis, and treatment of infection.
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Affiliation(s)
- Zhen Zhang
- Department of Dermatology, Xinhua Hospital, and Institute of Dermatology, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Jianying Liang
- Department of Dermatology, Xinhua Hospital, and Institute of Dermatology, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Ruoqu Wei
- Department of Dermatology, Xinhua Hospital, and Institute of Dermatology, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Xiaobo Feng
- Department of Dermatology, Xinhua Hospital, and Institute of Dermatology, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Lei Wang
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xian, China
| | - Liuhui Wang
- Department of Dermatology, Children's Hospital of Fudan University, Shanghai, China
| | - Piaoping Zhao
- Department of Dermatology, Children's Hospital of Fudan University, Shanghai, China
| | - Hong Yu
- Department of Dermatology, Xinhua Hospital, and Institute of Dermatology, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yan Gu
- Department of Dermatology, Xinhua Hospital, and Institute of Dermatology, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Zhirong Yao
- Department of Dermatology, Xinhua Hospital, and Institute of Dermatology, Shanghai Jiaotong University School of Medicine, Shanghai, China.
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