Soil amoeba blamed in the deaths of two organ transplant recipients
Two patients who received solid organ transplants in Arizona have died as a result of a parasite they got from the donated organs.
Balamuthia mandrillaris infecting brain tissue
Image/CDC
One man, a liver recipient and another who receive a kidney and pancreas died as a result of transplant-related encephalitis due to the microscopic amoeba, Balamuthia mandrillaris. Two other recipients of organs from the same donor, a heart and a kidney donor are alive and are not presenting with symptoms.
This is the second cluster of transplant-related encephalitis due to B. mandrillaris in less than a year.Last December there was another cluster in Mississippi where one kidney recipient died and another went into a coma and later recovered.
B. mandrillaris is a microscopic amoeba found in the environment in soil and has been isolated from humans and animals (horses, dogs and sheep) at autopsy.
The amoeba enters the respiratory system or through the skin and from there it can invade the central nervous system through the bloodstream causing granulomatous amebic encephalitis (GAE) in those with compromised immune systems.
It can be especially dangerous to people undergoing organ transplants, whose immune systems are purposely weakened so their bodies don’t reject their new organs.
Human infections with this amoeba are extraordinarily rare with only 150 cases reported worldwide in the past two decades.
Balamuthiais one of several agents of severe or fatal encephalitis along with West Nile virus, and rabies that have been transmitted through organ transplantation in recent years
Organs for transplant are routinely tested for a variety of infectious diseases (HIV, hepatitis B and C among others) prior to transplantation. However, very rarely an unusual organism shows up that’s not tested for. Organ donors are screened through medical history, etc to identify infectious risks. However, creating standards that eliminate all risk for infectious disease transmission is not feasible.
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