ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2019
The Epidemiology and Clinical Features of Balamuthia mandrillaris Disease in the United States, 1974-2016.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 79 papers, 2 of them syntheses that pooled it.
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Who cites it
79 citing papers in PubMed, 2 syntheses or guidelines pooled it, 151 citations in OpenAlex.
- Neurosurgical Biopsy and Resection for Diagnosis and Treatment of Balamuthia mandrillaris Amebic Encephalitis, United States.Emerging infectious diseases · 2026Pooled it
- The added value of metagenomic next-generation sequencing in central nervous system infections: a systematic review of case reports.Infection · 2025Pooled it
- Granulomatous amoebic encephalitis: pathogenesis, diagnostic advances, therapeutic challenges, and emerging treatment strategies.Medical microbiology and immunology · 2026Review
- Epidemiology and Clinical Features of Balamuthia mandrillaris Infection, China.Emerging infectious diseases · 2026Review
- Fatal Case of Balamuthia Amoebic Encephalitis in a Patient With MOG Antibody-Associated Disease.Open forum infectious diseases · 2026Article
- A unified digital twin framework for predicting therapeutic response to central nervous system infections by pathogenic free-living amoebae.Parasitology research · 2026Review
- Integrating Molecular Pathogenesis and Host Response into a Digital Twin Framework for Predicting Therapeutic Outcomes inACS omega · 2026Article
- Low Zoonotic Pathogen Burden in Free-Roaming Cats Revealed by 18S rRNA Metabarcoding: A Baseline Study from an Insular Natura 2000 Site in Spain.Animals : an open access journal from MDPI · 2026Article
- Drug susceptibility of a clinical isolate ofAntimicrobial agents and chemotherapy · 2026Article
- A Rare Case of FatalCase reports in infectious diseases · 2026Article
- The first reported case ofFrontiers in medicine · 2026Article
- Free-Living Amoebae Infections: Case Reports Identified at a Reference Parasitology Laboratory in Argentina.Acta parasitologica · 2025Article
- Free-Living Amoebae Infections: Case Reports Identified at a Reference Parasitology Laboratory in Argentina.Acta parasitologica · 2025Article
- Imaging findings of Balamuthia mandrillaris amoebic encephalitis in 2 cases with different prognosis and literature review.BMC neurology · 2025Review
- Strain-dependent immune responses reveal a critical role of IL-17A in defense against Balamuthia mandrillaris.Parasites, hosts and diseases · 2025Article
- Next-Generation Sequencing for Diagnosis of Fatal Balamuthia Amoebic Encephalitis: A Case Report.Diagnostics (Basel, Switzerland) · 2025Article
- Isolation and Environmental Detection of Balamuthia mandrillaris in Isfahan, Iran.Environmental microbiology reports · 2025Article
- Pulmonary infection due toASM case reports · 2025Article
- Environmentally derived Balamuthia mandrillaris contains endosymbiotic bacteria.Parasitology research · 2025Article
- Potentially pathogenic free-living amoebae at very high altitude: Detection by multiplex qPCR in the Northern Altiplano fascioliasis hyperendemic area in Bolivia.One health (Amsterdam, Netherlands) · 2025Article
19 more citing papers are in PubMed but not listed here.
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Authors and funding
10 authors at 5 institutions in 1 country.
Funding
Abstract
backgroundBalamuthia mandrillaris is a free-living ameba that causes rare, nearly always fatal disease in humans and animals worldwide. B. mandrillaris has been isolated from soil, dust, and water. Initial entry of Balamuthia into the body is likely via the skin or lungs. To date, only individual case reports and small case series have been published.
methodsThe Centers for Disease Control and Prevention (CDC) maintains a free-living ameba (FLA) registry and laboratory. To be entered into the registry, a Balamuthia case must be laboratory-confirmed. Several sources were used to complete entries in the registry, including case report forms, CDC laboratory results, published case reports, and media information. SAS© version 9.3 software was used to calculate descriptive statistics and frequencies.
resultsWe identified 109 case reports of Balamuthia disease between 1974 and 2016. Most (99%) had encephalitis. The median age was 36 years (range 4 months to 91 years). Males accounted for 68% of the case patients. California had the highest number of case reports, followed by Texas and Arizona. Hispanics constituted 55% for those with documented ethnicity. Exposure to soil was commonly reported. Among those with a known outcome, 90% of patients died.
conclusionsBalamuthia disease in the United States is characterized by a highly fatal encephalitis that affects patients of all ages. Hispanics were disproportionately affected. The southwest region of the United States reported the most cases. Clinician awareness of Balamuthia as a cause of encephalitis might lead to earlier diagnosis and initiation of treatment, resulting in better outcomes.
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