Balamuthia mandrilaris amoebiasis is a fatal disease. It primarily affects the nasal pyramid or the skin, producing granulomatous amoebic lesions. The amoeba spread from the primary nasal lesion to the meninges where they infiltrate vessels. Thrombotic amoebic angitis produce infarcts of the central nervous system substance which then become infiltrated by amoeba. The primary cutaneous lesion can be present for weeks or even months. However, the appearance of neurological disease predicts a poor prognosis, in which death usually occurs within a few days or weeks.