{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T16:25:13Z","timestamp":1787934313463,"version":"build-2784847793"},"reference-count":7,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2023,2,21]],"date-time":"2023-02-21T00:00:00Z","timestamp":1676937600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,3,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>We present the case of a 61-year-old woman with a history of orthotopic heart transplant who was hospitalized with new-onset headache. Magnetic resonance imaging (MRI) of the brain revealed T2 hyperintense signal involving the left occipital lobe with leptomeningeal enhancement and mild vasogenic edema. Initial neurologic examination was normal; however, after 7 days she developed imbalance, visual disturbances, night sweats, bradyphrenia, alexia without agraphia, and right hemianopsia. Brain MRI showed enlargement of the left occipital mass and worsening edema. Stereotactic needle biopsy showed nondiagnostic necrosis. The patient continued to deteriorate despite dexamethasone. Cerebrospinal fluid (CSF) suggested infection, and cytomegalovirus CSF polymerase chain reaction (PCR) was positive. The patient received vancomycin, imipenem, and ganciclovir. After obtaining a positive serum beta-D-glucan (Fungitell), amphotericin was added. Despite best medical efforts, the patient died. Postmortem broad-range PCR sequencing of the brain tissue was positive for rare amoeba Balamuthia mandrillaris.<\/jats:p>","DOI":"10.1093\/ofid\/ofad094","type":"journal-article","created":{"date-parts":[[2023,2,21]],"date-time":"2023-02-21T12:17:29Z","timestamp":1676981849000},"source":"Crossref","is-referenced-by-count":5,"title":["<i>Balamuthia mandrillaris<\/i>\n                    Encephalitis Presenting as a Symptomatic Focal Hypodensity in an Immunocompromised Patient"],"prefix":"10.1093","volume":"10","author":[{"given":"Amra","family":"Sakusic","sequence":"first","affiliation":[{"name":"Department of Neurology, Mayo Clinic , Jacksonville, Florida , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Baibing","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Neurology, Mayo Clinic , Jacksonville, Florida , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimberly","family":"McPhearson","sequence":"additional","affiliation":[{"name":"Department of Neurocritical Care, Mayo Clinic , Jacksonville, Florida , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed","family":"Badi","sequence":"additional","affiliation":[{"name":"Department of Neurology, Mayo Clinic , Jacksonville, Florida , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2326-0633","authenticated-orcid":false,"given":"William D","family":"Freeman","sequence":"additional","affiliation":[{"name":"Department of Neurology, Mayo Clinic , Jacksonville, Florida , USA"},{"name":"Department of Neurocritical Care, Mayo Clinic , Jacksonville, Florida , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josephine F","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Mayo Clinic , Jacksonville, Florida , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason L","family":"Siegel","sequence":"additional","affiliation":[{"name":"Department of Neurology, Mayo Clinic , Jacksonville, Florida , USA"},{"name":"Department of Neurocritical Care, Mayo Clinic , Jacksonville, Florida , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark E","family":"Jentoft","sequence":"additional","affiliation":[{"name":"Department of Pathology, Mayo Clinic , Jacksonville, Florida , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin M","family":"Oring","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Mayo Clinic , Jacksonville, Florida , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge","family":"Verdecia","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease, University of Florida, College of Medicine , Jacksonville, Florida , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James F","family":"Meschia","sequence":"additional","affiliation":[{"name":"Department of Neurology, Mayo Clinic , Jacksonville, Florida , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,2,21]]},"reference":[{"key":"2023032907504389400_","doi-asserted-by":"crossref","first-page":"1815","DOI":"10.1093\/cid\/ciy813","article-title":"The epidemiology and clinical features of Balamuthia mandrillaris disease in the United States","volume":"68","author":"Cope","year":"2019","journal-title":"Clin Infect Dis"},{"key":"2023032907504389400_","doi-asserted-by":"crossref","first-page":"78","DOI":"10.4103\/tp.tp_36_21","article-title":"Balamuthia mandrillaris: an opportunistic, free-living ameba\u2014an updated review","volume":"11","author":"Bhosale","year":"2021","journal-title":"Trop Parasitol"},{"key":"2023032907504389400_","first-page":"1165","article-title":"Balamuthia mandrillaris transmitted through organ transplantation\u2014Mississippi","volume":"59","author":"Schlessinger","year":"2010","journal-title":"Morb Mortal Wkly Rep"},{"key":"2023032907504389400_","first-page":"1182","article-title":"Transplant-transmitted Balamuthia mandrillaris\u2014Arizona","volume":"59","author":"Mbaeyi","year":"2010","journal-title":"Morb Mortal Wkly Rep"},{"key":"2023032907504389400_","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1186\/s13244-019-0703-0","article-title":"How clinical imaging can assess cancer biology","volume":"10","author":"Garc\u00eda-Figueiras","year":"2019","journal-title":"Insights Imaging"},{"key":"2023032907504389400_","first-page":"1563","article-title":"Cerebral post-transplant lymphoproliferative 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