Abstract
ABSTRACT.
This case report describes a rare cutaneous facial infection caused by
Balamuthia mandrillaris
. A 5-year-old boy presented with a red plaque on his left cheek lasting 14 months that had been previously misdiagnosed as a fungal infection without response to treatment. Routine fungal microscopy, histopathology, and molecular testing failed to identify the pathogen. Ultimately, next-generation sequencing of the skin lesion detected sequences of
B. mandrillaris
, which was subsequently confirmed by quantitative polymerase chain reaction testing. Examination of head magnetic resonance imaging confirmed no central nervous system involvement. The patient was treated with a combination regimen including lincomycin, sulfamethoxazole, and albendazole. After 3 months of therapy, the skin lesions subsided significantly, resulting in a favorable prognosis without the development of fatal granulomatous amebic encephalitis.