PubMed · 14952692
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M KENNEY. 1952. Micro-Kolmer complement fixation test for amebiasis.. https://doi.org/10.4269/ajtmh.1952.1.717
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Balamuthia mandrillaris is a free-living ameba and an opportunistic agent of lethal granulomatous amebic encephalitis (GAE) in humans and other mammals. Its supposed routes of infection have been largely assumed from what is known about Acanthamoeba spp. and Naegleria fowleri, other free-living amebae and opportunistic encephalitis agents. However, formal proof for any migratory pathway, from GAE patients or from animal models, has been lacking. Here, immunodeficient mice were infected with B. mandrillaris amebae by intranasal instillation, the most likely natural portal of entry. By means of classical and immunohistology, the amebae are shown to adhere to the nasal epithelium, progress along the olfactory nerves, traverse the cribriform plate of the ethmoid bone, and finally infect the brain. A similar invasion pathway has been described for N. fowleri. The data suggest that the olfactory nerve pathway is a likely route for natural infection of the brain by B. mandrillaris amebae.
The initial stages of Naegleria fowleri meningoencephalitis in mice were immunohistochemically characterized following the first 8 h post-intranasal inoculation. The events found after 8 h were: (1) amebas in contact with the mucous layer of the olfactory epithelium, (2) numerous parasites eliminated by extensive shedding of the mucous layer, and (3) many organisms reaching the nasal epithelium. In contrast to other works, we observed that after 24 h, amebas invaded the epithelium, without evidence of the disruption of the nasal mucosa. In addition some trophozoites invading through the respiratory epithelium were observed, suggesting an additional invasion route. The inflammatory response detected was scarce until 30 h post-inoculation. After 96 h, the inflammatory response was severe in the olfactory bulb and brain, and the tissue damage great. Consequently, an inflammatory reaction may enhance tissue damage but apparently does not destroy amebas which seem to proliferate in the olfactory bulb.
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