Naegleria fowleri
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Epidemiology
- affects children, young adults who have been swimming or diving in warm (> 80 F) freshwater lakes or pools
- 2 cases in 2011 linked to use tap water in Neti pots[3]
Pathology
- Naegleria enters the brain through the cribriform plate & olfactory bulbs
- it reaches the frontal lobes where it produces an acute hemorrhagic meningoencephalitis
- generally fatal within 1 week of symptom onset
- diagnosis generally made on autopsy
- trophozoites seen in tissue sections
- cysts rarely seen
Laboratory
- CSF analysis
- trophozoites may be seen on wet mount or stained specimens
- culture
- non-nutrient agar plates seeded with heat killed bacteria (Entamoeba coli)
- amoeba ingest bacteria leaving tracks
- amoeba may be seen under low power microscopy
- trophozoites
- measure 10-35 um
- large, round central karyosomes
- convert to flagellate forms when exposed to distilled water (after 1-2 hours)
- cysts
- spherical in shape
- 7-15 um in diameter
- Naegleria fowleri Ab in CSF
- Naegleria fowleri DNA
- see ARUP consult[4]
Management
- prognosis is uniformly poor
- only 4 survivors treated with high-dose intravenous & intrathecal amphotericin deoxycholate plus fluconazole, rifampin, azithromycin, miltefosine, & dexamethasone[5]
More general terms
Additional terms
References
- ↑ Clinical Diagnosis & Management by Laboratory Methods, 19th edition, J.B. Henry (ed), W.B. Saunders Co., Philadelphia, PA. 1996, pg 1269-70
- ↑ Harrison's Principles of Internal Medicine, 14th ed. Fauci et al (eds), McGraw-Hill Inc. NY, 1998, pg 1179
- ↑ 3.0 3.1 Wolchover N Neti pots linked to brain-eating amoeba deaths LiveScience http://vitals.msnbc.msn.com/_news/2011/12/16/9503070-neti-pots-linked-to-brain-eating-amoeba-deaths
- ↑ 4.0 4.1 ARUP Consult: Acanthamoeba and Naegleria The Physician's Guide to Laboratory Test Selection & Interpretation https://www.arupconsult.com/content/acanthamoeba-and-naegleria
- ↑ 5.0 5.1 Panosian Dunavan C Hazardous Waters: Lessons From a Brain-Eating Amoeba. Broader education and preventive efforts can help stop N. fowleri in its tracks Medpage Today. July 19, 2022 https://www.medpagetoday.com/opinion/second-opinions/99787
- ↑ Centers for Disease Control and Prevention Parasites - Naegleria http://www.cdc.gov/parasites/naegleria/faqs.html