Primary Amoebic Meningoencephalitis in an Infant due to<i>Naegleria fowleri</i>

Khanna, Vinay K.; Khanna, Ruchee; Hebbar, Shripad; Shashidhar, V; Mundkar, Sunil; Munim, Frenil; Annamalai, Karthick; Nayak, Deepak M; Mukhopadhayay, Chiranjay

doi:10.1155/2011/782539

Cited by 7 publications

(5 citation statements)

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“…Most victims of PAM are children or young adults in good health with a history of swimming in naturally warm or thermally polluted waters where growth of the amoebae is favored. Cases potentially linked to inhalation of drinking water or perhaps from contamination of premise plumbing have been suggested in reports of PAM among people with no recent history of swimming (Hunte et al, 2013;Kazi & Riaz, 2013;State of Louisiana Department of Health and Hospitals, 2013;Movahedi et al, 2012;Yoder et al, 2012;Khanna et al, 2011, Shakoor et al, 2011. Some of these nonswimming cases appear related to specific practices such as neti pot use or ritual nasal cleansing; however, the most recent cases in Karachi, Pakistan, have no connection to ritual nasal cleansing or any recreational water exposure (Zafar, 2014).…”

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confidence: 99%

Naegleria fowleri: An emerging drinking water pathogen

2014

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Naegleria fowleri (N. fowleri) is a free‐living, trophic amoeba that is nearly ubiquitous in the environment and can be present in high numbers in warm waters. It is the causative agent of primary amoebic meningoencephalitis (PAM), a rare but particularly lethal disease with a very low survival incidence. Although N. fowleri was isolated from drinking water supplies in Australia in the 1980s, it was not considered a drinking water threat in the United States until recent cases were associated with a groundwater system in Arizona and surface water systems in Louisiana. N. fowleri in drinking water treatment and distribution systems can be managed using disinfectant concentrations typically encountered in well‐run plants although nitrification and attendant low disinfectant residuals may pose a challenge for some systems. The greatest challenge for N. fowleri control is in premise plumbing systems where conditions are largely outside the control of utilities, residuals might be low or nonexistent, and where water temperatures could be high enough to support rapid growth of the amoebae. This article reviews published studies describing the environmental occurrence, survival, pathogenicity, and disinfection of N. fowleri. In addition, this article provides information about this little known and poorly understood parasite with respect to its occurrence in the environment; how the amoeba amplifies in water systems such that it can cause infection; how N. fowleri has been successfully controlled for decades in water systems through treatment and distribution system management in Australia; and the knowledge gaps and information needed to address N. fowleri as an emerging pathogen in US water supplies.

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confidence: 99%

Naegleria fowleri: An emerging drinking water pathogen

2014

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“…Of the 12 (48%) patients who had fatal outcomes, three were treated with empirical therapy and seven received amphotericin B in combination with other drugs. Amphotericin B treatment failure in these patients could have occurred due to extremely young age (Shenoy et al, 2002;Hebbar et al, 2005;Khanna et al, 2011), immunosuppression (Tilak et al, 2008;Gupta et al, 2009), or incomplete treatment (Kaushal et al, 2008b). The duration of treatment for PAM varied from nine days to six weeks (da Rocha-Azevedo et al, 2009).…”

Section: Naegleria Fowleri: Primary Amoebic Meningoencephalitismentioning

confidence: 99%

Central nervous system infections caused by pathogenic free-living amoebae: An Indian perspective

Raju¹

2022

Trop Biomed

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Pathogenic free-living amoebae (FLA), namely Acanthamoeba sp., Naegleria fowleri and Balamuthia mandrillaris are distributed worldwide. These neurotropic amoebae can cause fatal central nervous system (CNS) infections in humans. This review deals with the demographic characteristics, symptoms, diagnosis, and treatment outcomes of patients with CNS infections caused by FLA documented in India. There have been 42, 25, and 4 case reports of Acanthamoeba granulomatous amoebic encephalitis (GAE), N. fowleri primary amoebic meningoencephalitis (PAM), and B. mandrillaris meningoencephalitis (BAE), respectively. Overall, 17% of Acanthamoeba GAE patients and one of the four BAE patients had some form of immunosuppression, and more than half of the N. fowleri PAM cases had history of exposure to freshwater. Acanthamoeba GAE, PAM, and BAE were most commonly seen in males. Fever, headache, vomiting, seizures, and altered sensorium appear to be common symptoms in these patients. Some patients showed multiple lesions with edema, exudates or hydrocephalus in their brain CT/MRI. The cerebrospinal fluid (CSF) of these patients showed elevated protein and WBC levels. Direct microscopy of CSF was positive for amoebic trophozoites in 69% of Acanthamoeba GAE and 96% of PAM patients. One-fourth of the Acanthamoeba GAE and all the BAE patients were diagnosed only by histopathology following autopsy/biopsy samples. Twenty-one Acanthamoeba GAE survivors were treated with cotrimoxazole, rifampicin, and ketoconazole/amphotericin B, and all eleven PAM survivors were treated with amphotericin B alongside other drugs. A thorough search for these organisms in CNS samples is necessary to develop optimum treatment strategies.

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“…61 S. pedata has been identified as a rare cause of amoebic encephalitis. 63 Because of their appearance they have been curiously called "phantom" or "footprint" cells ( Figure 7B). In both centrifuged wet mount CSF specimens and fixed smears (Wright-Giemsa, Trichrome, Gram stain) it may be possible to observe pathogenic parasites.…”

Section: P a R Asi T Ic I Nf E Cti On Smentioning

confidence: 99%

“…In both centrifuged wet mount CSF specimens and fixed smears (Wright-Giemsa, Trichrome, Gram stain) it may be possible to observe pathogenic parasites. 63,64 Wet mounts of CSF may reveal amoeboid and actively motile flagellate forms of trophozoites. The background CSF shows a neutrophilic pleocytosis in early infection.…”

Section: P a R Asi T Ic I Nf E Cti On Smentioning

confidence: 99%

Cerebrospinal fluid cytology in nonmalignant aseptic meningeal disorders

Martínez‐Girón¹,

Pantanowitz

2017

Diagnostic Cytopathology

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Cerebrospinal fluid cytology examination is a common and reliable primary and/or complementary procedure for the diagnosis of central nervous system (CNS) disorders. This review provides an update of aseptic meningeal disorders that may be encountered in cytopathology practice. The article covers the cytological findings and helpful ancillary studies needed of nonmalignant aseptic CNS disorders such as viral, bacterial, fungal and parasitic infections, and other noninfectious diseases, such as Mollaret's meningitis (recurrent benign lymphocytic meningitis), Guillain-Barré syndrome, multiple Sclerosis, subarachnoid haemorrhage, and drug-induced disorders.

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Primary Amoebic Meningoencephalitis in an Infant due toNaegleria fowleri

Cited by 7 publications

References 7 publications

Naegleria fowleri: An emerging drinking water pathogen

Naegleria fowleri: An emerging drinking water pathogen

Central nervous system infections caused by pathogenic free-living amoebae: An Indian perspective

Cerebrospinal fluid cytology in nonmalignant aseptic meningeal disorders

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