Amoebic meningoencephalitis and disseminated infection caused by Balamuthia mandrillaris in a Western lowland gorilla (Gorilla gorilla gorilla)

Jenessa Gjeltema, Brigid Troan, Atis Muehlenbachs, Lindy Liu, Alexandre J. da Silva, Yvonne Qvarnstrom, Jeremy R. Tobias, Michael R. Loomis, Ryan S. de Voe

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

CASE DESCRIPTION A 22-year-old male gorilla (Gorilla gorilla gorilla) housed in a zoo was evaluated for signs of lethargy, head-holding, and cervical stiffness followed by development of neurologic abnormalities including signs of depression, lip droop, and tremors. CLINICAL FINDINGS Physical examination under general anesthesia revealed a tooth root abscess and suboptimal body condition. A CBC and serum biochemical analysis revealed mild anemia, neutrophilia and eosinopenia consistent with a stress leukogram, and signs consistent with dehydration. Subsequent CSF analysis revealed lymphocytic pleocytosis and markedly increased total protein concentration. TREATMENT AND OUTCOME Despite treatment with antimicrobials, steroids, and additional supportive care measures, the gorilla’s condition progressed to an obtunded mentation with grand mal seizures over the course of 10 days. Therefore, the animal was euthanized and necropsy was performed. Multifocal areas of malacia and hemorrhage were scattered throughout the brain; on histologic examination, these areas consisted of necrosis and hemorrhage associated with mixed inflammation, vascular necrosis, and intralesional amoebic trophozoites. Tan foci were also present in the kidneys and pancreas. Immunohistochemical testing positively labeled free-living amoebae within the brain, kidneys, eyes, pancreas, heart, and pulmonary capillaries. Subsequent PCR assay of CSF and frozen kidney samples identified the organism as Balamuthia mandrillaris, confirming a diagnosis of amoebic meningoencephalitis. CLINICAL RELEVANCE Infection with B mandrillaris has been reported to account for 2.8% of captive gorilla deaths in North America over the past 19 years. Clinicians working with gorillas should have a high index of suspicion for this diagnosis when evaluating and treating animals with signs of centrally localized neurologic disease.

Original languageEnglish (US)
Pages (from-to)315-321
Number of pages7
JournalJournal of the American Veterinary Medical Association
Volume248
Issue number3
DOIs
StatePublished - Feb 1 2016

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Balamuthia mandrillaris
Central Nervous System Protozoal Infections
Gorilla gorilla
meningoencephalitis
Gorilla
lowlands
kidneys
pancreas
hemorrhage
necrosis
Infection
infection
brain
trophozoites
neurodevelopment
nervous system diseases
Amoeba
abscess
seizures
lips

ASJC Scopus subject areas

  • veterinary(all)

Cite this

Amoebic meningoencephalitis and disseminated infection caused by Balamuthia mandrillaris in a Western lowland gorilla (Gorilla gorilla gorilla). / Gjeltema, Jenessa; Troan, Brigid; Muehlenbachs, Atis; Liu, Lindy; da Silva, Alexandre J.; Qvarnstrom, Yvonne; Tobias, Jeremy R.; Loomis, Michael R.; de Voe, Ryan S.

In: Journal of the American Veterinary Medical Association, Vol. 248, No. 3, 01.02.2016, p. 315-321.

Research output: Contribution to journalArticle

Gjeltema, Jenessa ; Troan, Brigid ; Muehlenbachs, Atis ; Liu, Lindy ; da Silva, Alexandre J. ; Qvarnstrom, Yvonne ; Tobias, Jeremy R. ; Loomis, Michael R. ; de Voe, Ryan S. / Amoebic meningoencephalitis and disseminated infection caused by Balamuthia mandrillaris in a Western lowland gorilla (Gorilla gorilla gorilla). In: Journal of the American Veterinary Medical Association. 2016 ; Vol. 248, No. 3. pp. 315-321.
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AU - Muehlenbachs, Atis

AU - Liu, Lindy

AU - da Silva, Alexandre J.

AU - Qvarnstrom, Yvonne

AU - Tobias, Jeremy R.

AU - Loomis, Michael R.

AU - de Voe, Ryan S.

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