Granulomatous amoebic meningoencephalitis in an immunocompetent patient.

Objective: To report a case of granulomatous amoebic encephalitis caused by Balamuthia mandrillaris.

Design: Case report.

Setting: University hospital.

Patients: An adult female patient without any apparent suppressor immune system factor had central nervous system infection caused by B mandrillaris.

Main Outcome Measures: Clinical, neuroimaging, and pathology findings.

Results: This study shows the diagnosis of B mandrillaris encephalitis suspected from a cerebral biopsy specimen and confirmed by immunohistochemical and polymerase chain reaction studies.

Conclusions: This study demonstrates that the diagnosis of amoebic encephalitis represents a clinical challenge and confirming diagnoses are made, in most cases, after death. High suspicion, histopathologic examination, and indirect immunofluorescence, polymerase chain reaction, and cytokine studies from tissue and cerebrospinal fluid are the main devices to reach the diagnosis.