Comparison of the clinical presentations of Naegleria fowleri primary amoebic meningoencephalitis with pneumococcal meningitis: a case–control study

Zahid, Mohammad Faizan; Shaukat, Muhammad Hamza Saad; Ahmed, Bilal; Beg, Mohammad Asim; Kadir, Muhammad Masood; Mahmood, Syed Faisal

doi:10.1007/s15010-016-0878-y

Cited by 8 publications

(5 citation statements)

References 21 publications

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“…According to the centre for disease control and prevention (CDC), only 138 cases of PAM in the United States have been reported from 1962 to 2015. Recently, there has been an increase in the number of reported PAM cases in Asian countries [ 14 , 17 , 18 ] perhaps due to increased awareness.…”

Section: Discussionmentioning

confidence: 99%

A case report: primary amoebic meningoencephalitis in a young Zambian adult

et al. 2017

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BackgroundPrimary amoebic meningoencephalitis (PAM) is a fulminant disease of the brain caused by Naegleria fowleri. Although the disease is rare, the case fatality rate is very high. In this report, we describe the first case of PAM in Zambia.Case presentationThe patient presented with sudden onset of seizures and fever on admission. On physical examination he was febrile, comatose and with a stiff neck. Cerebral spinal fluid (CSF) collected on admission did not reveal any organism on microscopy or culture but showed elevated white cell count. A working diagnosis of severe septicemia with acute meningoencephalitis was then made and the patient was started on IV Cephtriaxone (2 g) twice daily. Despite receiving treatment, his condition deteriorated. A second CSF sample collected on day 3 was also negative for bacteria and other organisms. However, a repeat CSF sample collected on day 8 revealed numerous motile organisms that were identified as Naegleria on microscopy and confirmed to be N. fowleri on polymerase chain reaction. The patient died on day 8 of hospital admission after having received one dose of Amphotericin B (50 mg). Features consistent with PAM were detected on autopsy.ConclusionThe isolation of N. fowleri in this patient calls for increased awareness among clinical and laboratory staff on suspected PAM cases to promptly diagnose and effectively manage the disease.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-017-2638-8) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

A case report: primary amoebic meningoencephalitis in a young Zambian adult

et al. 2017

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“…7 Additional cases of PAM diagnosed at Aga Khan University Hospital (AKUH), Karachi, Pakistan, have been described previously. 8,9 PAM can be diagnosed using microscopic methods, such as the wet film preparation of cerebrospinal fluid (CSF), CSF culture, and amebic antigen detection. In addition, the direct detection of parasite DNA by polymerase chain reaction (PCR) can be performed in CSF, biopsy, or tissue specimens.…”

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Case Series of Naegleria fowleri Primary Ameobic Meningoencephalitis from Karachi, Pakistan

Ghanchi

Jamil

Khan

et al. 2017

The American Journal of Tropical Medicine and Hygiene

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causes primary amoebic meningoencephalitis (PAM) which is almost always fatal. is waterborne, and its infections are usually associated with aquatic activities but it can also be transmitted via the domestic water supply. An increasing number of cases have been reported from Pakistan. Improved methods for diagnosis are required. We report the utility of polymerase chain reaction (PCR) for the diagnosis of in patients suspected of PAM. One hundred and sixteen cases suspected of having PAM were examined. Cerebrospinal fluid (CSF) specimens were tested at the Aga Khan University Hospital, Karachi. Nineteen CSF specimens were positive for using PCR. positive patients had a median age of 28 years and were 84% male and 16% female. Overall, CSF wet preparation microscopy was performed in 85 (73%) cases and identified that seven specimens were positive for motile trophozoites. The CSF wet preparation results were available for 15 of the 19 PCR positive CSF samples; seven (40%) wet preparations were positive. Our data highlight the threat of infection as a cause of PAM. It also emphasizes the utility of the PCR-based diagnosis of the amoeba for early diagnosis and management of the disease.

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“…These changes are similar to those in bacterial infection. However, it is not common for abundant red cells to be detected in bacterial meningoencephalitis (14). Moreover, the progression of PAM is more rapid than that of bacterial meningoencephalitis.…”

Section: Discussionmentioning

confidence: 99%

Case Report: Recognition of Devastating Primary Amoebic Meningoencephalitis (PAM) Caused by Naegleria fowleri: Another Case in South China Detected via Metagenomics Next-Generation Sequencing Combined With Microscopy and a Review

Chen

Che²,

Lin³

et al. 2022

Front. Trop. Dis

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IntroductionPrimary amoebic meningoencephalitis (PAM) caused by Naegleria fowleri is seldom reported in mainland China.MethodsOne case from South China was presented, and the clinical features of the PAM, especially the early CT features, were compared to those in the literatures from PubMed/Web of Science/China National Knowledge internet (CNKI).Case Presentation and ResultsA 47-year-old man with a high fever came to the fever clinic. Twelve hours later, the man lost consciousness and exhibited generalized tonic-clonic seizures and needed ventilator-controlled ventilation. Then, he was admitted to the neurology intensive care unit (NICU). The opening pressure of his cerebrospinal fluid (CSF) was over 500 mm H2O with highly increased leukocyte/protein levels and very low glucose levels. Three days after admission, high copy numbers of Naegleria fowleri amoebae were detected by metagenomics next-generation sequencing (mNGS) and cysts were visible with wet mount microscopy. Four days after admission, the patient experienced brain death. However, the relatives of the patient did not want to give up, and he received amphotericin B (AmB). During hospitalization, he suffered from severe damage to the liver and kidneys and electrolyte disorders that required continuous renal replacement therapy (CRRT).ReviewAll 20 included PAM patients suffered from fever. Seventeen of them had headache and neck stiffness. Ten of them showed generalized brain edema. To date, 7 cases of PAM have been reported in China. Only one patient survived. Most of the patients showed generalized brain edema. Only the surviving patient showed focal edema. He died three months later.ConclusionRapidly progressive meningoencephalitis in which the CSF results are similar to those suffered from a bacterial infection should be considered a possible case of PAM. It can be rapidly detected with microscopy in CSF wet mounts but needs further molecular investigation for confirmation, and mNGS should be a new method used for rapid and precise identification. Moreover, CRRT may prolong the survival time of PAM patients with multiple organ failure.

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Comparison of the clinical presentations of Naegleria fowleri primary amoebic meningoencephalitis with pneumococcal meningitis: a case–control study

Abstract: PAM and pneumococcal meningitis remain virtually indistinguishable; however, these predictive features should be validated in a prospective study and may lead to a viable algorithm for early management of these patients.

Cited by 8 publications

References 21 publications

A case report: primary amoebic meningoencephalitis in a young Zambian adult

A case report: primary amoebic meningoencephalitis in a young Zambian adult

Case Series of Naegleria fowleri Primary Ameobic Meningoencephalitis from Karachi, Pakistan

Case Report: Recognition of Devastating Primary Amoebic Meningoencephalitis (PAM) Caused by Naegleria fowleri: Another Case in South China Detected via Metagenomics Next-Generation Sequencing Combined With Microscopy and a Review

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