{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T20:21:06Z","timestamp":1791058866906,"version":"4.1.0"},"reference-count":32,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T00:00:00Z","timestamp":1778544000000},"content-version":"vor","delay-in-days":14,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,28]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Granulomatous amebic encephalitis (GAE) is a rare but frequently fatal infection of the central nervous system, with poorly defined epidemiology, clinicoradiological features, and prognostic factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a PRISMA-compliant systematic review of confirmed GAE cases registered with PROSPERO (CRD420251120627). MEDLINE, Embase, and Web of Science were searched from inception to September 2025. Two reviewers independently screened studies, extracted data, and assessed quality using the Joanna Briggs Institute checklist. Comparative analyses were performed between Acanthamoeba and Balamuthia infections and between survivors and nonsurvivors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 142 studies comprising 201 confirmed GAE cases were included. Cases were reported worldwide, predominantly from North America and Asia. Immunosuppression was documented in 58\/196 (29.6%) cases. Headache, altered mental status, fever, and seizures were the most common presenting features. Neuroimaging most frequently demonstrated space-occupying lesions (148\/190, 77.9%). Balamuthia mandrillaris accounted for 126\/201 (62.7%) infections and Acanthamoeba for 67\/201 (33.3%). Compared with Balamuthia infection, Acanthamoeba GAE was more often associated with immunocompromising conditions and meningeal involvement. Overall mortality was 146\/191 (76.4%). Deaths were significantly more frequent in Balamuthia infection, and hypoglycorrhachia (50\/101, 49.5%) emerged as a strong correlate of nonsurvival. Several antimicrobial agents were used more frequently among survivors, likely reflecting treatment intensity and survivor bias rather than definitive therapeutic efficacy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Granulomatous amebic encephalitis remains a devastating infection with persistently high mortality. Distinct organism-specific phenotypes and markers of disease severity may aid early diagnosis and prognostication.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ofid\/ofag289","type":"journal-article","created":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T11:38:46Z","timestamp":1778153926000},"source":"Crossref","is-referenced-by-count":1,"title":["Clinical Profile, Epidemiology, and Outcomes of Granulomatous Amebic Encephalitis: A Systematic Review"],"prefix":"10.1093","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9687-2836","authenticated-orcid":false,"given":"Nitin","family":"Gupta","sequence":"first","affiliation":[{"name":"Department of Infectious Disease, Kasturba Medical College, Manipal Academy of Higher Education , Manipal ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shreya","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Parasitology, Post Graduate Institute of Medical Education and Research , Chandigarh ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kavita","family":"Salian","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease, Kasturba Medical College, Manipal Academy of Higher Education , Manipal ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonali","family":"Singh","sequence":"additional","affiliation":[{"name":"Division of Neurology, Department of Pediatrics, Hospital for Sick Children, University of Toronto , Toronto, ON ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shreya","family":"Das Adhikari","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Kasturba Medical College, Manipal Academy of Higher Education , Manipal ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4565-0707","authenticated-orcid":false,"given":"Mukund","family":"Gupta","sequence":"additional","affiliation":[{"name":"All India Institute of Medical Sciences , Jodhpur, Rajasthan ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6894-2262","authenticated-orcid":false,"given":"Carl","family":"Boodman","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, Institute of Tropical Medicine , Antwerp ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin P","family":"Grobusch","sequence":"additional","affiliation":[{"name":"Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam Public Health \u2013 Global Health, Amsterdam Infection & Immunity , Amsterdam ,","place":["The Netherlands"]},{"name":"Masanga Medical Research Unit (MMRU) , Masanga ,","place":["Sierra Leone"]},{"name":"Centre de Recherches M\u00e9dicales en Lambar\u00e9n\u00e9 , Lambar\u00e9n\u00e9, Gabon"},{"name":"Institut f\u00fcr Tropenmedizin und Deutsches Zentrum f\u00fcr Infektiologie (DZIF), Universit\u00e4t T\u00fcbingen , T\u00fcbingen ,","place":["Germany"]},{"name":"Institute of Molecular Medicine and Infectious Diseases, University of Cape Town , Cape Town ,","place":["South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5926-5885","authenticated-orcid":false,"given":"Tirlangi Praveen","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease, Kasturba Medical College, Manipal Academy of Higher Education , Manipal ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,5,12]]},"reference":[{"key":"2026052006115083300_ofag289-B1","doi-asserted-by":"crossref","first-page":"1261","DOI":"10.3390\/ijms22031261","article-title":"Immunopathogenicity of acanthamoeba spp. In the brain and lungs","volume":"22","author":"Kot","year":"2021","journal-title":"Int J Mol Sci"},{"key":"2026052006115083300_ofag289-B2","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1128\/CMR.16.2.273-307.2003","article-title":"Acanthamoeba spp. As agents of disease in humans","volume":"16","author":"Marciano-Cabral","year":"2003","journal-title":"Clin Microbiol Rev"},{"key":"2026052006115083300_ofag289-B3","doi-asserted-by":"crossref","first-page":"341","DOI":"10.3347\/kjp.2019.57.4.341","article-title":"Acanthamoeba in Southeast Asia - 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