Assessment of blood-brain barrier penetration of miltefosine used to treat a fatal case of granulomatous amebic encephalitis possibly caused by an unusual Balamuthia mandrillaris strain

Parasitology Research
S L RoyGovinda S Visvesvara

Abstract

Balamuthia mandrillaris, a free-living ameba, causes rare but frequently fatal granulomatous amebic encephalitis (GAE). Few patients have survived after receiving experimental drug combinations, with or without brain lesion excisions. Some GAE survivors have been treated with a multi-drug regimen including miltefosine, an investigational anti-leishmanial agent with in vitro amebacidal activity. Miltefosine dosing for GAE has been based on leishmaniasis dosing because no data exist in humans concerning its pharmacologic distribution in the central nervous system. We describe results of limited cerebrospinal fluid (CSF) and serum drug level testing performed during clinical management of a child with fatal GAE who was treated with a multiple drug regimen including miltefosine. Brain biopsy specimens, CSF, and sera were tested for B. mandrillaris using multiple techniques, including culture, real-time polymerase chain reaction, immunohistochemical techniques, and serology. CSF and serum miltefosine levels were determined using a liquid chromatography method coupled to tandem mass spectrometry. The CSF miltefosine concentration on hospital admission day 12 was 0.4 μg/mL. The serum miltefosine concentration on day 37, about 80 h pos...Continue Reading

References

Sep 1, 1990·Cancer Treatment Reviews·H Eibl, C Unger
Dec 1, 1990·Journal of Clinical Microbiology·G S VisvesvaraM Anderson
Jul 1, 1993·The Journal of Eukaryotic Microbiology·G S VisvesvaraA J Martinez
Mar 1, 1996·Antimicrobial Agents and Chemotherapy·S JaruratanasirikulS Tussanasunthornwong
Jul 21, 1997·The Medical Journal of Australia·R P ReedJ R Forsyth
Jan 9, 2003·Journal of Clinical Microbiology·Gregory C BootonPaul A Fuerst
Jul 5, 2003·Journal of Clinical Microbiology·Frederick L SchusterGovinda S Visvesvara
Oct 30, 2003·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Thomas R DeetzGovinda S Visvesvara
Sep 7, 2004·Microbiology·Thelma H DunnebackeGregory C Booton
Sep 7, 2004·Veterinary Pathology·O ForemanH De Cock
Oct 27, 2004·Emerging Infectious Diseases·Frederick L SchusterGovinda S Visvesvara
Apr 6, 2006·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Frederick L SchusterCarol A Glaser
Oct 6, 2006·Journal of Clinical Microbiology·Yvonne QvarnstromAlexandre J da Silva
Oct 13, 2006·Parasitology Research·Peter J FinninRobin B Gasser
Mar 8, 2008·Journal of Chromatography. B, Analytical Technologies in the Biomedical and Life Sciences·Thomas P C DorloJos H Beijnen
Jun 4, 2008·Antimicrobial Agents and Chemotherapy·Thomas P C DorloPeter J de Vries
Nov 29, 2008·Parasitology Research·Albrecht F KiderlenPhiroze S Tata
Feb 25, 2009·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Frederick L SchusterCarol A Glaser
May 21, 2009·The Journal of Immunology : Official Journal of the American Association of Immunologists·Pallavi WadhoneBhaskar Saha
Aug 18, 2009·Parasitology Research·Maryam NiyyatiBasilio Valladares
Feb 4, 2010·Pediatrics·Larry Curtis CaryWilliam Robertson
Jun 17, 2010·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Dalila Y MartínezEduardo Gotuzzo
Mar 26, 2011·The Journal of Eukaryotic Microbiology·Arine F AhmadSimon Kilvington
Jun 10, 2011·Clinical and Vaccine Immunology : CVI·Zuzana KucerovaGovinda S Visvesvara
Jun 15, 2011·Journal of Neuroparasitology·Christine Anne Petersen, M Heather West Greenlee
May 16, 2012·Antimicrobial Agents and Chemotherapy·Thomas P C DorloPeter J de Vries
Jul 27, 2012·The Journal of Antimicrobial Chemotherapy·Thomas P C DorloPeter J de Vries
Jul 25, 2013·The Journal of Eukaryotic Microbiology·Yvonne QvarnstromGovinda S Visvesvara

❮ Previous
Next ❯

Citations

Oct 16, 2015·Parasitology Research·Maryam NiyyatiZohreh Lasjerdi
Mar 12, 2016·Parasitology Research·Carsten Balczun, Patrick L Scheid
Nov 9, 2016·Microbiological Research·Allan J GuimaraesRegina H Saramago Peralta
Jan 3, 2018·Current Opinion in Infectious Diseases·Roland NauHelmut Eiffert
Jun 10, 2020·Antimicrobial Agents and Chemotherapy·Maarten J SarinkJaap J van Hellemond
Mar 15, 2019·Drug Delivery and Translational Research·Salma A SoudiLabiba K El-Khordagui
Aug 2, 2017·Clinical Pharmacokinetics·Anke E KipThomas P C Dorlo
Mar 3, 2021·Clinical and Translational Science·Alexandre TaravaudSébastien Pomel
Jul 1, 2021·The Journal of Antimicrobial Chemotherapy·Adrien ContejeanCaroline Charlier
Sep 4, 2020·ACS Chemical Neuroscience·Hye Jee HahnAnjan Debnath

❮ Previous
Next ❯

Related Concepts

Related Feeds

Blood Brain Barrier

The blood brain barrier is a border that separates blood from cerebrospinal fluid. Discover the latest search on this highly selective semipermeable membrane here.

Blood Brain Barrier Regulation in Health & Disease

The blood brain barrier is essential in regulating the movement of molecules and substances in and out of the brain. Disruption to the blood brain barrier and changes in permeability allow pathogens and inflammatory molecules to cross the barrier and may play a part in the pathogenesis of neurodegenerative disorders. Here is the latest research in this field.

Addiction

This feed focuses mechanisms underlying addiction and addictive behaviour including heroin and opium dependence, alcohol intoxication, gambling, and tobacco addiction.

CSF & Lymphatic System

This feed focuses on Cerebral Spinal Fluid (CSF) and the lymphatic system. Discover the latest papers using imaging techniques to track CSF outflow into the lymphatic system in animal models.

Amoebiasis

Amoebiasis, infection by the protozoan parasite Entamoeba histolytica, remains a global health problem, despite the availability of effective treatment. Here is the latest research.

Blood Brain Barrier Chips

The blood brain barrier (BBB) is comprised of endothelial cells that regulate the influx and outflux of plasma concentrations. Lab-on-a-chip devices allow scientists to model diseases and mechanisms such as the passage of therapeutic antibodies across the BBB. Discover the latest research on BBB chips here.