Granulomatous Amebic Encephalitis by Balamuthia mandrillaris in Pediatrics: Description of Seven Cases in an Institution

Abstract Introduction Granulomatous amebic encephalitis (GAE) caused by Balamuthia mandrillaris is a rare and frequently fatal infection of the central nervous system (CNS), especially in pediatric patients. Objective To describe a series of seven pediatric cases of GAE caused by Balamuthia mandrillaris and analyze the current literature on this pathology. Materials and Methods A retrospective review of pediatric cases diagnosed with GAE by Balamuthia mandrillaris at the Hospital de Pediatría J.P. Garrahan between 2000 and 2023 was conducted. Clinical, radiological, histopathological data, and therapeutic management of these patients were analyzed. A literature search was conducted in the virtual library Pub-Med in high-impact factor journals. Results Of the seven cases analyzed, six underwent biopsy and died despite receiving required treatment. The only survivor to date was the patient who had the amebic granuloma completely removed, including the capsule, and completed specific antiparasitic treatment. Conclusion GAE by Balamuthia mandrillaris has an extremely high mortality rate in pediatric patients, occurring very shortly after the onset of the disease. In this case series, we have demonstrated that the complete surgical resection of the granulomatous lesion allowed the patient to remain disease-free with a seven-month follow-up.