@article {4696,
	title = {Transmission of Balamuthia mandrillaris by Organ Transplantation},
	volume = {63},
	year = {2016},
	month = {Oct},
	pages = {7},
	abstract = {BACKGROUND:

During 2009 and 2010, 2 clusters of organ transplant-transmitted Balamuthia mandrillaris, a free-living ameba, were detected by recognition of severe unexpected illness in multiple recipients from the same donor.
METHODS:

We investigated all recipients and the 2 donors through interview, medical record review, and testing of available specimens retrospectively. Surviving recipients were tested and treated prospectively.
RESULTS:

In the 2009 cluster of illness, 2 kidney recipients were infected and 1 died. The donor had Balamuthia encephalitis confirmed on autopsy. In the 2010 cluster, the liver and kidney-pancreas recipients developed Balamuthia encephalitis and died. The donor had a clinical syndrome consistent with Balamuthia infection and serologic evidence of infection. In both clusters, the 2 asymptomatic recipients were treated expectantly and survived; 1 asymptomatic recipient in each cluster had serologic evidence of exposure that decreased over time. Both donors had been presumptively diagnosed with other neurologic diseases prior to organ procurement.
CONCLUSIONS:

Balamuthia can be transmitted through organ transplantation with an observed incubation time of 17-24 days. Clinicians should be aware of Balamuthia as a cause of encephalitis with high rate of fatality, and should notify public health departments and evaluate transplant recipients from donors with signs of possible encephalitis to facilitate early diagnosis and targeted treatment. Organ procurement organizations and transplant centers should be aware of the potential for Balamuthia infection in donors with possible encephalitis and also assess donors carefully for signs of neurologic infection that may have been misdiagnosed as stroke or as noninfectious forms of encephalitis.},
	doi = {10.1093/cid/ciw422},
	author = {Farnon, EC and Kokko, KE and Budge, PJ and Mbaeyi, C and Lutterloh, EC and Qvarnstrom, Y and da Silva, AJ and Shieh, WJ and Roy, SL and Paddock, CD and Sriram, R and Zaki, SR and Visvesvara, GS and Kuehnert, MJ and Weiss, J and Komatsu, K and Manch, R and Ramos, A and Echeverria, L and Moore, A and Zakowski, P and Kittleson, M and Kobashigawa, J and Yoder, J and Beach, M and Mahle, W and Kanter, K and Geraghty, PJ and Navarro, E and Hahn, C and Fujita, S and Stinson, J and Trachtenberg, J and Byers, P and Cheung, M and Jie, T and Kaplan, B and Gruessner, R and Bracamonte, E and Viscusi, C and Gonzalez-Peralta, R and Lawrence, R and Fratkin, J and Butt, F}
}
