A man suffering from an infection from an incredibly rare brain-eating amoeba has reportedly been saved by an old UTI drug.
The infection, which is almost always fatal, could not claim the man’s life thanks to the medicine. The case, reported in the journal Emerging Infectious Diseases, detailed the 54-year-old man’s ordeal, who had visited a hospital in Northern California after suffering a seizure in August 2021.
The brain-eating pathogen is known as Balamuthia mandrillaris—a single-celled, free-living amoeba, which is ubiquitous in the soil and water.
The amoeba’s route of entry into the body is through the nose or skin wounds. Its ultimate destination is the brain via the bloodstream. When this happens, it causes a condition known as granulomatous amebic encephalitis or GAE, according to Gizmodo.
The infection can stay in the body for years before symptoms like fever, headaches, seizures, and behavioral changes appear. Symptom onset is followed by a fatality rate of around 90%. While GAE caused by B. mandrillaris is rare–around 200 cases have been documented worldwide since its discovery–it can affect anyone, even healthy individuals.
When the man was admitted to the hospital following the seizure, brain scans were conducted. In the MRI scans, masses and swelling on the left side of his brain could be seen. Following initial treatment, the patient was transferred to doctors at the University of California’s San Francisco Medical Center.
When the initial tests could not find the culprit, the man was discharged. However, some doctors decided to review his case again. The healthcare professionals tested the man’s biopsy samples for a possible amoeba infection. Voila! The test came back positive for B. mandrillaris, a month after his initial visit. The man was promptly readmitted to the hospital.
Fresh MRIs revealed new brain lesions, and the Californian man was put on the only known standard treatment for GAE, which consisted of a cocktail of antimicrobials. Though his condition initially improved as his lesions decreased in size, the toxicity of the drugs proved too much for his body to bear. Since doctors could not find a safe and effective combination of drugs, the patient’s condition began to deteriorate.
The doctors pored over the medical literature for an alternative. Luckily, lab research from their own colleagues at UCSF come to light, where the drug nitroxoline was suggested as an effective anti-amoeba treatment. After approximately 100 days since the man’s first hospital visit, and after approval from his family and the Food and Drug Administration, the doctors started the man on nitroxoline.
The start was rough for the man as he experienced kidney problems, but eventually, he began improving. The brain lesions decreased and after a week of treatment, the man was discharged from the hospital.
Nitroxoline has been used as a bacteria-killing drug for urinary tract infections for a long time. However, it’s not commercially available in the U.S. For this reason, the doctors had to procure the drug from a pharma company in China.
The man is currently taking a combination of medications, including nitroxoline. But the doctors plan to wean him off these drugs within a year.