Naegleria Infection Follow-up

  • Author: Subhash Chandra Parija, MBBS, MD, PhD, FRCPath; Chief Editor: Burke A Cunha, MD   more...
 
Updated: Aug 11, 2011
 

Further Inpatient Care

Patients with primary amebic meningoencephalitis (PAM) should be monitored in the ICU.

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Deterrence/Prevention

The only definite way to evade N fowleri infections is to abstain from water-related activities.[28]

Since N fowleri trophozoites and cysts are susceptible to chlorine, swimming pools should be adequately chlorinated. Case clusters have been reported in association with poorly chlorinated pools.

Strongly consider closure of a site if a case of PAM occurs.

Warm water is known to be more at risk of harboring these organisms. Thus, avoiding activities in bodies of warm fresh water, hot springs, and water around power plants, which may be thermally polluted, may be advisable. In addition, when taking part in such activities, it would be better to avoid the accidental entry of water into the nose.

There are no public health criteria established for what levels of amebae present are acceptable or unacceptable.[29]

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Complications

PAM is typically fatal. Death is due to pulmonary edema or cardiorespiratory arrest within a week of appearance of the first symptoms. Persistent seizures may occur in patients who have otherwise recovered.

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Prognosis

PAM carries a very poor prognosis, with a mortality rate of greater than 95%

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Contributor Information and Disclosures
Author

Subhash Chandra Parija, MBBS, MD, PhD, FRCPath  Director-Professor of Microbiology, Head of Department of Microbiology, Jawaharlal Institute, Postgraduate Medical Education and Research, India

Subhash Chandra Parija, MBBS, MD, PhD, FRCPath is a member of the following medical societies: Indian Academy of Tropical Parasitology, Indian Association of Biomedical Scientists, Indian Association of Medical Microbiologists, Indian Association of Pathologists and Microbiologists, Indian Medical Association, Indian Society for Parasitology, National Academy of Medical Sciences, India, and Royal College of Pathologists

Disclosure: Jawaharlal Institute of Postgraduate Medical education & Research , Pondicherry , India Salary Employment

Coauthor(s)

Michael Stuart Bronze, MD  Professor, Stewart G Wolf Chair in Internal Medicine, Department of Medicine, University of Oklahoma Health Science Center

Michael Stuart Bronze, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians, American Medical Association, Association of Professors of Medicine, Infectious Diseases Society of America, Oklahoma State Medical Association, and Southern Society for Clinical Investigation

Disclosure: Nothing to disclose.

Barnett Gibbs, MD  Assistant Chief, Department of Clinical Trials, Walter Reed Army Institute of Research, Infectious Disease Service, National Capital Consortium; Assistant Professor of Medicine, Uniformed Services University of the Health Sciences

Disclosure: Nothing to disclose.

Diane H Johnson, MD  Assistant Director, Assistant Professor, Department of Internal Medicine, Division of Infectious Diseases, Winthrop-University Hospital, State University of New York at Stony Brook School of Medicine

Diane H Johnson, MD is a member of the following medical societies: American College of Physicians, American Medical Association, American Medical Women's Association, American Society for Microbiology, and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Specialty Editor Board

Daniel R Lucey, MD, MPH  Chief, Fellowship Program Director, Department of Internal Medicine, Division of Infectious Diseases, Washington Hospital Center; Professor, Department of Internal Medicine, Uniformed Services University of the Health Sciences

Daniel R Lucey, MD, MPH is a member of the following medical societies: Alpha Omega Alpha and American College of Physicians

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Thomas M Kerkering, MD  Chief of Infectious Diseases, Virginia Tech Carilion School of Medicine

Thomas M Kerkering, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians, American Public Health Association, American Society for Microbiology, American Society of Tropical Medicine and Hygiene, Infectious Diseases Society of America, Medical Society of Virginia, and Wilderness Medical Society

Disclosure: Nothing to disclose.

Eleftherios Mylonakis, MD  Clinical and Research Fellow, Department of Internal Medicine, Division of Infectious Diseases, Massachusetts General Hospital

Eleftherios Mylonakis, MD is a member of the following medical societies: American Association for the Advancement of Science, American College of Physicians, American Society for Microbiology, and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Chief Editor

Burke A Cunha, MD  Professor of Medicine, State University of New York School of Medicine at Stony Brook; Chief, Infectious Disease Division, Winthrop-University Hospital

Burke A Cunha, MD is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

References

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  29. Lower Colorado River Authority. Lower Colorado River Authority: Energy, Water, Community Services. Available at http://www.lcra.org. Accessed August 2011.

 
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H&E-stained photomicrograph (magnified 125X) that shows the cytoarchitectural histpathology found in a case of primary amoebic meningoencephalitis (PAM), caused by Naegleria gruberi. Courtesy of the CDC/Dr. George R. Healy.
 
 
 
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