eMedicine Specialties > Infectious Diseases > CNS Infections
Naegleria Infection: Follow-up
Updated: Aug 3, 2009
Follow-up
Further Inpatient Care
Patients with primary amebic meningoencephalitis (PAM) should be monitored in the ICU.
Deterrence/Prevention
- 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.
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.
Prognosis
PAM carries a very poor prognosis, with a mortality rate of greater than 95%.
Miscellaneous
Medicolegal Pitfalls
Consider primary amebic meningoencephalitis (PAM) in all patients with meningoencephalitis, especially with an appropriate exposure history.
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Follow-up: Naegleria Infection |
| Multimedia: Naegleria Infection |
| References |
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References
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Centers for Disease Control and Prevention (CDC). Primary amebic meningoencephalitis--Arizona, Florida, and Texas, 2007. MMWR Morb Mortal Wkly Rep. May 30 2008;57(21):573-7. [Medline].
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Cervantes-Sandoval I, Serrano-Luna Jde J, García-Latorre E, Tsutsumi V, Shibayama M. Mucins in the host defence against Naegleria fowleri and mucinolytic activity as a possible means of evasion. Microbiology. Dec 2008;154(Pt 12):3895-904. [Medline].
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Factsheet of Naeglaria fowleri. Available at http://www.cdc.gov/ncidod/dpd/parasites/Naegleria/factsht_naegleria.htm.
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Naegleria fowleri. Wikipedia. Available at http://en.wikipedia.org/wiki/Naegleria_fowleri. Accessed 9/25/2008.
Parija SC. Amoebae. In: Textbook of Medical Parasitology: Protozoology & Helminthology. 3rd ed. New Delhi, India: All India Publishers and Distributors; 2006:26-61.
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Réveiller FL, Cabanes PA, Marciano-Cabral F. Development of a nested PCR assay to detect the pathogenic free-living amoeba Naegleria fowleri. Parasitol Res. May 2002;88(5):443-50. [Medline].
Marciano-Cabral F, MacLean R, Mensah A, LaPat-Polasko L. Identification of Naegleria fowleri in domestic water sources by nested PCR. Appl Environ Microbiol. Oct 2003;69(10):5864-9. [Medline].
Johnson PE, Deromedi AJ, Lebaron P, Catala P, Havens C, Pougnard C. High throughput, real-time detection of Naegleria lovaniensis in natural river water using LED-illuminated Fountain Flow Cytometry. J Appl Microbiol. Sep 2007;103(3):700-10. [Medline].
Vargas-Zepeda J, Gómez-Alcalá AV, Vásquez-Morales JA, Licea-Amaya L, De Jonckheere JF, Lares-Villa F. Successful treatment of Naegleria fowleri meningoencephalitis by using intravenous amphotericin B, fluconazole and rifampicin. Arch Med Res. Jan-Feb 2005;36(1):83-6. [Medline].
Further Reading
Keywords
Naegleria fowleri, Naegleria infection, N fowleri, primary amebic meningoencephalitis, PAM, purulent meningoencephalitis, N fowleri meningoencephalitis, Naegleria fowleri meningoencephalitis, Naegleria australiensis, Naegleria italica, Naegleria philippinensis, N australiensis, N italica, N philippinensis
Follow-up: Naegleria Infection