Meningoencephalitis by Naegleria fowleri: epidemiological study in Anzoategui state, Venezuela

Abstract

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.

Diagnosis of Keratitis by Cultivation, Fluorescence Microscopy and PCR has Uncovered that AcanthamoebaEmits Auto Fluorescence

“…Acanthamoeba, Balamuthia, Naegleria and Sappinia are human pathogens causing infections in the central nervous system (CNS), eyes, lungs and skin [3,7,13,39]. Naegleria fowleri causes Primary Amoebic Meningoencephalitis (PAM), which is a fulminant, necrotizing and haemorrhagic meningoencephalitis and later leading to death [26,39].…”

“…In contrast to PAM, GAE is a more subacute or chronic infection in immunocompromised or debilitated individuals of all ages [3,7,13,39,42]. The entry portal is thoughtfully to be the skin or lower respiratory tract, with subsequent haematogenous dissemination to the CNS [37].…”

Ante mortem diagnosis of amoebic encephalitis in a haematopoietic stem cell transplanted patient

“…Acanthamoeba [15], Balamuthia [3], Naegleria [4] and Sappinia [7] are human pathogens causing infections in the central nervous system (CNS), eyes, lungs and skin. Acanthamoeba causes a visionthreatening disease (keratitis).…”