Triathlete Contracts Rare Amoeba From Open Water

**Montgomery County Surgeon Battles Extremely Rare Brain-Eating Amoeba After Summer Swims**

MONTGOMERY COUNTY, TX – A Montgomery County orthopedic surgeon and avid triathlete is fighting for his life against an incredibly rare and aggressive amoebic infection, *Balamuthia mandrillaris*, believed to have been contracted during open water training swims across the Houston area last summer. Dr. Robert S. Bales, a respected member of the medical community, was diagnosed in December 2023 after months of debilitating symptoms.

Dr. Bales, known for his dedication to sports and medicine, began experiencing severe headaches in early September. Over the following weeks, his condition rapidly deteriorated, progressing to include vomiting, seizures, and a troubling decline in both his cognitive and motor skills. The definitive diagnosis of *Balamuthia mandrillaris* came as a shock, revealing the devastating cause of his mysterious illness.

The amoeba, distinct from the more commonly known *Naegleria fowleri*, causes Granulomatous Amebic Encephalitis (GAE), a severe and often fatal infection of the brain and spinal cord. Unlike *Naegleria*, which typically causes a rapid onset of symptoms after nasal exposure in warm freshwater, *Balamuthia* infections are often slower to manifest, making diagnosis challenging. It is believed the amoeba entered Dr. Bales’ system through his nose or an open wound while he trained in various open bodies of water, including Lake Conroe, Lake Houston, Galveston Bay, and the Brazos River, during the summer months. *Balamuthia mandrillaris* is found in soil and freshwater throughout the world.

The rarity of Dr. Bales’ diagnosis underscores the severity of his plight. Worldwide, fewer than 200 cases of *Balamuthia mandrillaris* have been reported since its identification in 1986, making it one of the most obscure and dangerous infections known. The survival rate for GAE caused by *Balamuthia* is tragically low, often less than 10%.

Currently, Dr. Bales is undergoing aggressive chemotherapy treatments at Houston Methodist Hospital, as a team of specialists works tirelessly to combat the devastating effects of the infection. The treatment regimen often involves a combination of antimicrobial drugs, some of which are used in cancer therapies, due to the amoeba’s unique resistance mechanisms.

Public health officials, including the Centers for Disease Control and Prevention (CDC) and the Texas Department of State Health Services (DSHS), continually monitor for such rare infections. While *Balamuthia mandrillaris* cases are exceptionally uncommon, experts recommend general precautions for individuals engaging in open water activities, such as avoiding swimming in warm, stagnant water, limiting water entry into the nose, and covering open wounds to minimize potential exposure to various environmental pathogens.

The Montgomery County community is rallying around Dr. Bales and his family as he bravely confronts this extraordinary medical challenge, highlighting the hidden dangers that can lurk in natural environments, even for the most prepared and healthy individuals. His battle serves as a stark reminder of the microscopic threats present in nature and the critical importance of rapid, accurate diagnosis for rare diseases.