Balamuthia mandrillaris – a brief overview of the parasite causing encephalitis

Balamuthia mandrillaris is a unicellular protist, known to cause infection of the central nervous system. The life cycle of B. mandrillaris is divided into vegetative, infectious trophozoites and dormant cysts. The ability of B. mandrillaris to produce a rare but fatal infection has resulted in considerable interest in this parasite by the scientific community. However, the pathogenic mechanisms remain incompletely understood. Additionally, symptoms vary from patient to patient, hence diagnosis is often delayed. This delay in diagnosis is compounded further with limited availability of expertise or tools for diagnosis resulting in symptom-based personalized therapy, nonetheless, the prognosis remains extremely poor. Recent studies have shown the use of nanomedicine as a promising approach against parasitic infections such as B. mandrillaris. This, together with the availability of whole genome sequence information, coupled with high throughput genomics-based approaches to make B. mandrillaris genetically tractable should be of interest to study its molecular pathogenetic mechanisms and as a model organism to study cellular differentiation, growth, motility, and biochemical pathways. Overall, future research should move beyond the descriptive pathology of Balamuthia infection towards a mechanistic understanding of host entry, blood-brain barrier traversal, neuronal damage, immune evasion, and cyst biology.