MINIREVIEW Pathogenic and opportunistic free-living amoebae: Acanthamoeba spp., Balamuthia mandrillaris , Naegleria fowleri , and Sappinia diploidea Govinda S. Visvesvara1, Hercules Moura2 & Frederick L. Schuster3 1Division of Parasitic Diseases, National Center for Infectious Diseases, Atlanta, Georgia, USA; 2Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA; and 3Viral and Rickettsial Diseases Laboratory, California Department of Health Services, Richmond, California, USA Correspondence: Govinda S. Visvesvara, Abstract Centers for Disease Control and Prevention, Chamblee Campus, F-36, 4770 Buford Among the many genera of free-living amoebae that exist in nature, members of Highway NE, Atlanta, Georgia 30341-3724, only four genera have an association with human disease: Acanthamoeba spp., USA. Tel.: 1770 488 4417; fax: 1770 488 Balamuthia mandrillaris, Naegleria fowleri and Sappinia diploidea. Acanthamoeba 4253; e-mail:
[email protected] spp. and B. mandrillaris are opportunistic pathogens causing infections of the central nervous system, lungs, sinuses and skin, mostly in immunocompromised Received 8 November 2006; revised 5 February humans. Balamuthia is also associated with disease in immunocompetent chil- 2007; accepted 12 February 2007. dren, and Acanthamoeba spp. cause a sight-threatening infection, Acanthamoeba First published online 11 April 2007. keratitis, mostly in contact-lens wearers. Of more than 30 species of Naegleria, only one species, N. fowleri, causes an acute and fulminating meningoencephalitis in DOI:10.1111/j.1574-695X.2007.00232.x immunocompetent children and young adults. In addition to human infections, Editor: Willem van Leeuwen Acanthamoeba, Balamuthia and Naegleria can cause central nervous system infections in animals. Because only one human case of encephalitis caused by Keywords Sappinia diploidea is known, generalizations about the organism as an agent of primary amoebic meningoencephalitis; disease are premature.