A case of primary amoebic meningoencephalitis produced by Naegleria fowleri was diagnosed in the Independencia county of Anzoategui State, Venezuela. This case motivated the realization of the present epidemiological study with the aim of identifying free-living amoebae in this area. Representative water samples were taken and physicochemical and microbiologic analyses were carried out. Trophozoites and cysts of Naegleria spp, were detected in 44.4% (n=4). An excellent concordance was found among the observations of free-living amoebae in smears and those of monoxenic cultures in non nourishing agar with Klebsiella pneumoniae (Kappa=1; p= 0.003). A variable load of aerobic mesophils was obtained. Moulds and yeast averages presented 3.0 CFU/ml (SD+ 2.0) and 102.9 CFU/ml (SD± 32.2), respectively. One hundred per cent of the samples presented a most probable number of total and fecal coliforms of 240,000 NMP/100mL. Naegleria spp was present in waters of the Independence county of Anzoategui State, which constitutes a risk for people that use these sources. Key-works: Amoebic meningoencephalitis. Epidemiology. Free-living amoebae. Naegleria fowleri. RESUMOUm caso de meningoencefalite amebiana primária, causada por Naegleria fowleri, foi diagnosticada no município de Independência no Estado de Anzoategui, Venezuela. Este caso motivou a realização deste estudo epidemiológico com o objetivo de identificar amebas de vida livre nessa área. Foram colhidas amostras representativas de água e realizadas análises fisicoquímicas e microbiológicas. Trofozoítos e cistos de Naegleria spp foram detectados em 44,4% (n=4). Verificou-se excelente concordância entre a observação das amebas de vida livre em esfregaços e aquelas de culturas monoxênicas em ágar não nutriente com Klebsiella pneumoniae (Kappa=1; p=0,003). Obteve-se uma carga variável de microrganismos mesófilos aeróbicos. As médias de mofos e leveduras foram de 3,0 CFU/ml (SD+2,0) e 102,9 CFU/ml(SD+32,2), respectivamente. Cem por cento das amostras apresentaram um número maior provável de coliformes totais e fecais de 240.000 NMP/100ml. Naegleria spp estava presente nas águas do município de Independência no Estado de Anzoategui, o que constitui um risco para a população que usa essas fontes.
We reviewed the etiologic aspects, clinical symptoms, complementary studies, differential diagnosis and treatment of alternating hemiplegia of childhood (AHC). AHC is an uncommon illness of uncertain pathophysiology that provokes crisis of transient hemiplegia affecting one hemibody or occasionally both at the same time. Clinical symptoms of AHC usually begin before the age of 18 months and in some cases may present in the neonatal period. Clinical symptoms include abnormal ocular movements such as nystagmus and dystonic or tonic posturing. Hemiplegic attacks are not associated with alteration of consciousness. Hemiplegia may disappear after arousal and may reappear 10 to 20 minutes after arousal in children with AHC. The diagnosis of AHC is clinically made, and most of the clinically used diagnostic tests result in negative. The treatment of AHC includes flunarizine. It is necessary to suspect this diagnosis to identify patients with AHC.
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