{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T02:55:00Z","timestamp":1783392900577,"version":"3.54.6"},"reference-count":23,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec id=\"st1\">\n<jats:title>Background<\/jats:title>\n<jats:p>Brain infection by free-living amoebae can present as granulomatous amoebic encephalitis if caused by <jats:italic>Acanthamoeba<\/jats:italic> spp. or <jats:italic>Balamuthia mandrillaris<\/jats:italic>, or as primary amoebic meningoencephalitis if caused by <jats:italic>Naegleria fowleri<\/jats:italic>, the latter with high morbidity and mortality. Diagnosis is made by studying cerebrospinal fluid or tissue samples by direct microscopy, culture, polymerase chain reaction, or immunofluorescence. There is no specific treatment, and there are only reports of success with prolonged use of combined drugs.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st2\">\n<jats:title>Cases Description<\/jats:title>\n<jats:p>We present five cases with a diagnosis of brain infection by free-living amoebae treated at the Hospital Almenara. The patients received surgical treatment, and four of them also received antiparasitic treatment; in one case, the diagnosis was post-mortem. Antiparasitic treatment consisted of a combination of miltefosine, voriconazole, and albendazole mainly, with an average time of 4.8 months. All cases were diagnosed after the initial surgery, and two patients died. Diagnosis in all cases was by direct microscopy, but typing of the free-living amoeba involved was not possible.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st3\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Brain infection by free-living amoebae is a disease with high morbimortality, which requires early diagnosis for a better prognosis if long-term combined treatment is established.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/sni_65_2025","type":"journal-article","created":{"date-parts":[[2025,5,2]],"date-time":"2025-05-02T10:14:49Z","timestamp":1746180889000},"page":"166","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Encephalitis-causing free-living amoebic infections in children: A rare and fatal disease"],"prefix":"10.25259","volume":"16","author":[{"given":"John","family":"Vargas-Urbina","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Hospital Nacional Guillermo Almenara Irigoyen, La Victoria, Lima, Peru"},{"name":"Department of Neurosurgery, Cl\u00ednica Internacional, San Borja, Lima, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ra\u00fal","family":"Martinez-Silva","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hospital Nacional Guillermo Almenara Irigoyen, La Victoria, Lima, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Rojas-Panta","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hospital Nacional Guillermo Almenara Irigoyen, La Victoria, Lima, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel","family":"Ponce-Manrique","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hospital Nacional Guillermo Almenara Irigoyen, La Victoria, Lima, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jerson","family":"Flores-Castillo","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Hospital Nacional Guillermo Almenara Irigoyen, La Victoria, Lima, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dalila Y.","family":"Mart\u00ednez","sequence":"additional","affiliation":[{"name":"Department of Infectious, Tropical and Dermatological Diseases, Hospital Nacional Cayetano Heredia, Lima, Peru"},{"name":"School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfonso Martin","family":"Cabello-Vilchez","sequence":"additional","affiliation":[{"name":"Alexander Von Humboldt Institute of Tropical Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John A.","family":"Cabrera-Enriquez","sequence":"additional","affiliation":[{"name":"Service of Pediatric Infectious Diseases, Hospital Nacional Guillermo Almenara Irigoyen, La Victoria, Lima, Peru"},{"name":"School of Medicine, Faculty of Health Sciences, San Ignacio de Loyola University, Lima, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10894","published-online":{"date-parts":[[2025,5,2]]},"reference":[{"key":"10.25259\/SNI_65_2025\/ref-1","first-page":"e18888","article-title":"Naegleria fowleri in Central and South America: The brain-eating amoeba is it in Peru?","volume":"16","year":"2023","journal-title":"Rev Cuerpo Med HNAAA"},{"key":"10.25259\/SNI_65_2025\/ref-2","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1093\/ajcp\/49.1.84","article-title":"Amebic meningoencephalitis due to free-living amebas of the Hartmannella (Acanthamoeba)-Naegleria Group","volume":"49","author":"Callicott","year":"1968","journal-title":"Am J Clin 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