1/35. Primary meningoencephalitis by naegleria fowleri: first reported case from Mangalore, South india.A fatal case of primary amebic meningoencephalitis (PAM) in a 5-month-old infant is described. The disease may have been contracted during bathing. The source of water was from an artificial well. The clinical presentation, the isolation of the ameba from the cerebrospinal fluid, the poor response to amphotericin b, and the ultimate fatal outcome are all consistent with the diagnosis of PAM. On the basis of its ability to grow at temperatures above 30 degrees C, the morphology of the trophozoite, and the presence of flagellate forms, the ameba was identified as naegleria fowleri. Pathogenic N. fowleri amebae were recovered from samples of water from the well. To our knowledge this case represents the second case of PAM in an infant in the absence of the history of swimming.- - - - - - - - - - ranking = 1keywords = water (Clic here for more details about this article) |
2/35. December 2002: 19-year old male with febrile illness after jet ski accident.The December 2002 COM. A 19-year-old healthy male fell into stagnant water of the intercostal waterway (salt water of South florida), following a jet ski accident. He sustained minor superficial injuries but engulfed significant quantities of water and sediment. A few days later he developed bifrontal headaches, vomiting, a stiff neck and a temperature of 102 degrees F. A CT scan on admission without contrast was negative. The CSF had markedly elevated white count but bacterial and fungal cultures were negative. He became progressively lethargic. On the fifth day he developed seizure activity. He expired the next day despite antibiotics. Gross examination of the brain at autopsy revealed edema, cerebellar tonsillar herniation and purulent meningitis. Microscopic examination revealed a massive leptomeningeal inflammatory infiltrate composed of neutrophils, lymphocytes, and numerous histiocyte-like cells. The inflammatory infiltrate extended into the cerebral parenchyma in numerous areas also involving the cerebellum, brainstem and ventricular system. Given the exposure to stagnant water (later confirmed to be a man-made fresh water lake), and the numerous histiocytic-like cells, suspicion for an amebic etiology of the disease process was raised and the CDC identified the ameba as naegleria fowleri. Infection by naegleria fowleri, a free-living ameba, occurs after exposure to polluted water in man-made fresh water lakes, ponds, swimming pools, particularly during the warm weather months when the thermophilic ameba grows well. The pathologic substrate of the infection is an acute hemorrhagic, necrotizing meningo-encephalitis mainly at the base of the brain, brainstem and cerebellum occurring in young, healthy individuals.- - - - - - - - - - ranking = 4keywords = water (Clic here for more details about this article) |
3/35. Environmental isolation of balamuthia mandrillaris associated with a case of amebic encephalitis.This report describes the first isolation of the ameba balamuthia mandrillaris from an environmental soil sample associated with a fatal case of amebic encephalitis in a northern california child. Isolation of the ameba into culture from autopsied brain tissue confirmed the presence of Balamuthia: In trying to locate a possible source of infection, soil and water samples from the child's home and play areas were examined for the presence of Balamuthia: The environmental samples (plated onto nonnutrient agar with escherichia coli as a food source) contained, in addition to the ameba, a variety of soil organisms, including other amebas, ciliates, fungi, and nematodes, as contaminants. Presumptive Balamuthia amebas were recognized only after cultures had been kept for several weeks, after they had burrowed into the agar. These were transferred through a succession of nonnutrient agar plates to eliminate fungal and other contaminants. In subsequent transfers, axenic Naegleria amebas and, later, tissue cultures (monkey kidney cells) served as the food source. Finally, the amebas were transferred to cell-free axenic medium. in vitro, the Balamuthia isolate is a slow-growing organism with a generation time of approximately 30 h and produces populations of approximately 2 x 10(5) amebas per ml. It was confirmed as Balamuthia by indirect immunofluorescence staining with rabbit anti-Balamuthia serum and human anti-Balamuthia antibody-containing serum from the amebic encephalitis patient. The environmental isolate is similar in its antimicrobial sensitivities and identical in its 16S ribosomal dna sequences to the Balamuthia isolate from the deceased patient.- - - - - - - - - - ranking = 0.5keywords = water (Clic here for more details about this article) |
4/35. Cerebrospinal acanthamebic granulomas. Case report.The authors present the case of a previously healthy 26-year-old man who presented with cerebrospinal acanthamebic granulomas, and they review the literature on acanthamebic granulomas of the central nervous system (CNS). The appearance of the lesion on imaging studies suggested the presence of tuberculous granulomas, which are common in india, and antituberculosis treatment was started. Despite surgical excision of a granuloma located in the right temporoparietal region and an intramedullary granuloma at T7-8, the disease progressed and resulted in death. Unlike other cases, this patient was not immunocompromised, had no history of engaging in water activities, and had no ulcers on his body, leaving in question the mode of entry used by the ameba. Acanthamebic granulomas can cause severe infections in healthy patients as well as in sick ones. This disease should be considered in the differential diagnosis when treating infective granulomas of the CNS.- - - - - - - - - - ranking = 0.5keywords = water (Clic here for more details about this article) |
5/35. Primary amebic meningoencephalitis--georgia, 2002.In early September 2002, the georgia Division of public health and CDC were notified about a fatal case of primary amebic meningoencephalitis (PAM) caused by naegleria fowleri in a boy aged 11 years who had recently swum in a local river. This report summarizes the case investigation. In response to this case, the district health department recommended that local community authorities advise persons to avoid swimming in this river during periods of high temperature and low water depth.- - - - - - - - - - ranking = 0.5keywords = water (Clic here for more details about this article) |
6/35. Disseminated cutaneous acanthamebiasis: a case report and review of the literature.The genus acanthamoeba includes species of free-living soil and water ameba that have been implicated in a small number of human diseases. acanthamoeba species have been identified as the etiologic agents in 2 well-defined clinical entities, amebic keratitis and granulomatous amebic encephalitis (GAE). Less commonly, acanthamoeba species have been identified as the cause of disseminated disease in debilitated and immunocompromised patients. Cutaneous acanthamebiasis, often a reflection of disseminated disease, is an increasingly recognized infection since the emergence of acquired immunodeficiency syndrome (AIDS) and the use of immunosuppressive drugs. The disease portends a poor prognosis and is uniformly fatal if the infection involves the central nervous system (CNS). We describe a patient with advanced AIDS who presented with disseminated cutaneous lesions, headache, and photophobia, and in whom a diagnosis of cutaneous acanthamebiasis was made based on the results of a skin biopsy. A multidrug therapeutic regimen was begun that included sulfadiazine; the patient responded favorably to treatment. This paper also reviews 36 previously reported cases of cutaneous acanthamebiasis with delineation of clinical, diagnostic, histologic, and prognostic features, as well as discusses treatment options.- - - - - - - - - - ranking = 0.5keywords = water (Clic here for more details about this article) |
7/35. Successful treatment of naegleria fowleri meningoencephalitis by using intravenous amphotericin b, fluconazole and rifampicin.BACKGROUND: Primary amebic meningoencephalitis (PAM) is an emerging disease with a rapidly fatal outcome. Only eight reports of cured cases have appeared in the medical literature to date. methods: A 10-year-old boy developed PAM caused by naegleria fowleri 1 week after swimming in an irrigation canal. He was admitted to our hospital after 9 h of severe headache and vomiting, fever, ataxic gait, mild confusion, and seizures were evident. trophozoites were identified in the cerebrospinal fluid (CSF). Treatment with intravenous (i.v.) dexamethasone, amphotericin b, fluconaloze, and oral rifampicin was started. After several hours of conflicting clinical signs, recovery began, and on the third day he was conscious again. Hospital discharge occurred on day 23, after a normal brain CT scan. There was no sequel to the disease during the following 12 months. RESULTS: The amebas present in the CSF were identified and confirmed as N. fowleri after observation of wet mounts and of cultures seeded on 1.5% non-nutrient agar plates covered with escherichia coli, vegetative and cystic forms, enflagellation experiments in distilled water at 98 degrees F, temperature tolerance testing and by indirect immunofluorescence using N. fowleri LEE antibody. The genotype was determined by PCR amplification and sequencing of the internal transcribed spacers (ITS) including the 5.8S rDNA. CONCLUSIONS: Early treatment of PAM by i.v. administration of amphotericin b and fluconazole, and oral administration of rifampicin can offer some hope of cure for this devastating disease.- - - - - - - - - - ranking = 0.5keywords = water (Clic here for more details about this article) |
8/35. Early detection and identification of amphizoic amoebae from nasal exudates of a symptomatic case.A man visited the Out Patient Department of the hospital for Tropical Diseases in February 2004 with low grade fever and severe headache for a week. He had the history of diving in a natural pond 2-3 days before the onset of the disease. A thick bloody mucous was observed from the nasal discharge. Fresh microscopic observation of the exudates in 0.85% sodium chloride revealed numerous active amoeba trophozoites. Two groups of the trophozoites were observed The first group was 10 micro sized amoeba with active directional movement by lobopodia and the second group was 15-30 micro sized amoeba with active multiprogressive movement by filopodia. Few flagellate forms were observed after exflagellation in distilled water and some polygonal cysts were also found. Giemsa' stain was used to differentiate the amoeba trophozoites from the leukocytes. It was concluded that this patient was infected by both Naegleria spp. and acanthamoeba spp. This is the first report of double infection of free-living amoeba in a symptomatic and non-fatal patient.- - - - - - - - - - ranking = 0.5keywords = water (Clic here for more details about this article) |
9/35. Fatal case of naegleria fowleri meningo-encephalitis in an infant: case report.Primary amoebic meningo-encephalitis (PAM) is extremely rare and is caused by naegleria fowleri. It is ?commonly seen in older children who swim in water contaminated with Naegleria species. It is very rare to contract the illness by any other means. We report a case of PAM in an infant aged 6 months. To the best of our knowledge, only one other case of PAM in an infant has been reported from india. A high index of suspicion is required in infants who manifest similarly to pyogenic meningitis but whose CSF shows no bacterial organisms so that a wet mount of a CSF sample can be done for early detection of naegleria fowleri infection and appropriate intervention.- - - - - - - - - - ranking = 0.5keywords = water (Clic here for more details about this article) |
10/35. Disseminated acanthamoebiasis after lung transplantation.protozoan infections in organ transplant recipients are rare. We report a fatal case of disseminated acanthamoebiasis in a bilateral lung transplant recipient that presented with cutaneous lesions, respiratory failure, and seizures. acanthamoeba infection may be identified in transplant recipients with exposure to water who develop non-healing cutaneous ulcers with granulomatous inflammation. Cutaneous lesions are the initial manifestation of infection and a harbinger of dissemination. Early institution of combination anti-microbial therapy is therefore necessary for effective treatment and prevention of lethal spread to the central nervous system.- - - - - - - - - - ranking = 0.5keywords = water (Clic here for more details about this article) |
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