Science magazine reported that a decades-old medicine for urinary tract infections (UTIs) may also work for brain-eating amoeba infections, which kill the great majority of persons who catch them.
A recent case report published in the journal Emerging Infectious Diseases in January described a 54-year-old man whose brain was penetrated by the amoeba Balamuthia mandrillaris. He was sent to the University of California San Francisco (UCSF) Medical Center after an MRI detected a mystery tumor on his brain's left side, which turns out to be an infection caused by the amoeba and not a tumor.
Repurposed UTI Drug Used To Treat Rare Brain-Eating Amoeba Infection; How Do People Get Infected With This Deadly Bacteria?
54-Year-Old Man Infected With Rare Brain-Eating Amoeba
As per the Centers for Disease Control and Prevention (CDC), Balamuthia mandrillari is a single-celled organism that lives in dust, soil, and water that can infect humans by entering through skin wounds, cuts, or through the lungs when inhaled.
Upon infiltration, the amoeba travels to the brain and triggers a rare brain infection called "granulomatous amebic encephalitis," which kills about 90% of affected people. The CDC notes that the infection could initially appear mild but become more severe after several months.
In the case study, the man initially received a treatment from Northern California hospital for an unexplained seizure. But after undergoing magnetic resonance imaging (MRI), doctors found a mass on the left side of the brain that looks like being surrounded by swelling.
He was then transferred to UCSF where doctors took samples of his brain tissue and clear fluid. They analyzed the man's sample and found that the amoeba B. mandrillaris has infected the man's brain.
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Rare Brain Infection Treated Using UTI Drug
The patient's doctors suggested an extensive prescription of antiparasitic, antibiotic, and antifungal medications after consulting with the CDC. Infectious disease expert Dr. Natasha Spottiswoode from UCSF said that the treatment plan was suggested because it was the same method used for patients who survived.
However, the man experienced significant adverse effects from the treatment plan, including renal failure, but he was still not treated for the amoeba infection.
As they look for a better solution, Spottiswoode found the 2018 report, titled "Functional Assessment of 2,177 U.S. and International Drugs Identifies the Quinoline Nitroxoline as a Potent Amoebicidal Agent against the Pathogen Balamuthia mandrillaris" published in mBio.
In the study, UCSF research found evidence that the antibiotic known as nitroxoline can kill the deadly amoeba in laboratory settings. However, it is not approved in the US so they have to seek permission from the Food and Drug Administration (FDA) to use it. After receiving approval, they started administering it to the patient and observed a drastic improvement within a week.
He was soon discharged from the hospital and advised to continue taking nitroxoline at home along with other medicines. Eventually, his use of his medications will cease as soon as clinicians find it necessary. But in the meantime, UCSF research is overseeing a second case of the same amoeba who also started taking the antibiotic and showing similar improvements.
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