Balamuthia mandrillaris in South America: an emerging potential hidden pathogen in Perú.

Balamuthia mandrillaris is a free living amoeba that can be isolated from soil. It is an emerging pathogen causing skin lesions as well as CNS involvement with a fatal outcome if untreated. Further, infections can sometimes can also appear in peripheral areas such as extremities (usually knee), or trunk. Moreover, it often progresses to an infiltrative lesion that occasionally becomes ulcerated. In countries like Peru, a skin lesion will precede other symptoms. This primary cutaneous lesion can be present for weeks or even months. However, the appearance of neurological disease predicts a poor prognosis. Diagnosis requires a high level of suspicion.

PrestoBlue® and AlamarBlue® are equally useful as agents to determine the viability of Acanthamoeba trophozoites.

Acanthamoeba is an opportunistic pathogen which is the causal agent of several human infections such as Granulomatous Amoebic Encephalitis, Acanthamoeba keratitis and other disseminated infections. Furthermore, current therapeutic measures against Acanthamoeba infections are arduous, and show limited efficacy against the cyst stage of Acanthamoeba. There is a pressing need to search and evaluate new therapeutic agents against these protozoa. Our approach for evaluating possible new drugs is an initial in vitro screening assay based on general metabolic activity of the cells. In this study we compare two agents, AlamarBlue® and PrestoBlue® for this initial screen. Both reagents can be used to indicate metabolism by changes in their absorbance or fluorescence. The assay is carried out in a 96-well plate format and fluorescence can be measured after an inoculation period of as little as 10 min, but more typically 96 h. This to the best of our knowledge this is the first time that both compounds are directly compared using absorbance and fluorescence measurement. We conclude that for the specific case of Acanthamoeba both agents AlamarBlue® and PrestoBlue® are equally useful to determine cell viability.

Isolation and Genomic Analysis of an Intracellular Mycobacterium gordonae from a Free-Living Acanthamoeba sp. in a Hospital Environment in Lima, Peru.

Mycobacterium gordonae is a nontuberculous mycobacterium found in diverse environments and is considered an opportunistic pathogen in immunocompromised patients. We report the draft genome sequence of a Mycobacterium gordonae strain isolated from a free-living amoeba found in a nosocomial environment in Lima, Peru.

Successful Treatment of Primary Amoebic Meningoencephalitis Using a Novel Therapeutic Regimen Including Miltefosine and Voriconazole.

The genus Naegleria consists of free-living amoebae widely distributed worldwide in soil and freshwater habitats. Primary amoebic meningoencephalitis (PAM) is an uncommon and most likely fatal disease. The incubation period is approximately 7 days. The first symptoms are headache, nasal congestion, fever, vomiting, stiff neck within 3-4 days after the first symptoms, confusion, abnormal behavior, seizures, loss of balance and body control, coma, and death. We describe the case of a child who presented with PAM due to Naegleria sp., fully recovered from the infection without apparent sequels after treatment with a regimen that included miltefosine and voriconazole.