Balamuthia's life cycle, like the Acanthamoeba, consists of a cystic stage and a trophozoite stage, both of which are infectious, and both of which can be identified as inclusions in the brain tissue on microscopic examination of brain biopsies performed on infected individuals. The trophozoite is pleomorphic and uninucleated, but binucleate forms are occasionally seen. Cysts are also uninucleated possessing three walls: an outer thin irregular ectocyst, an inner thick endocyst, and a middle amorphous fibrillar mesocys