When you think of the most dangerous infections out there, the brain-eating amoeba is probably not the first thing that comes to mind. But this single-celled organism is a real threat, killing 90% of those who contract it. Thankfully, a decades-old drug may be the answer to stopping this deadly infection. In this blog post, we’ll discuss a recent case report that found that a repurposed drug can battle brain-eating amoeba infections and the hope it brings for those affected.
The case report, published in January in the journal Emerging Infectious Diseases, describes a 54-year-old man whose brain was infiltrated by the amoeba Balamuthia mandrillaris. This amoeba lives in dust, soil and water, and can enter the body through skin wounds and cuts or through the lungs, when it’s inhaled. It can then infiltrate the bloodstream and travel to the brain, triggering a very rare infection called “granulomatous amebic encephalitis” that kills around 90% of people affected.
The man initially received treatment at a Northern California hospital for an unexplained seizure, but the treatment triggered severe side effects, including kidney failure, and he wasn’t yet amoeba-free. In search of another solution, the medical team prescribed an aggressive regimen of antiparasitic, antibacterial and antifungal drugs, but this wasn’t enough.
That’s when a 2018 report, published in the journal mBio, came to the rescue. The report found evidence that an antibiotic called nitroxoline can kill Balamuthia mandrillaris in laboratory settings. The drug is approved in Europe, but not the U.S., so the medical team sought permission from the Food and Drug Administration to use it; they received approval, started the patient on nitroxoline and observed rapid improvement, within a week.
The patient was soon discharged from the hospital and he continued to take nitroxoline at home, along with other medications; his clinicians plan to eventually discontinue his use of the drugs. In the meantime, UCSF doctors are overseeing the case of a second Balamuthia mandrillaris-infected patient who’s started receiving nitroxoline and are seeing similar improvements.
The promise of nitroxoline as a treatment for brain-eating amoeba infections is a huge step forward in the fight against this deadly infection. While more research is needed to confirm its effectiveness, this repurposed drug could be a life-saving treatment for those affected.