Naegleria: Primary amebic encephalitis (PAM)

The incubation period varies from 1 to 14 days. Its clinical presentation can mimic that of bacterial meningitis. Early symptoms include fevers, headaches, lethargy, nausea, and vomiting. More severe manifestations that develop later include confusion, neck stiffness, photophobia, seizures, and cranial nerve abnormalities. Primary amebic encephalitis progresses rapidly and eventually leads to coma and death in most cases.

CSFglucose being low to normal, elevated proteins, and polymorphonuclear cells (predominant leukocytosis). CSF pressures are elevated, and pressures of up to 600 mm H20 have been reported in patients with PAM

Identification of N. fowleri can be missed on gram stains and cultures as the fixation procedure destroys them. Visualization can be achieved on wet mounts, hematoxylin, and eosin (H and E), periodic acid-Schiff (PAS), Giemsa-Wright staining, or modified trichrome stains. Very few laboratories in the United States can test for Naegleria fowleri. Antigen detection by immunohistochemical staining techniques can be performed on CSF or tissue sample, along with PCR and cultures. Serological testing

Rx:Amphotericin B,MiletefosineFluconazole Rifampin

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