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Naegleria fowleri

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Summary

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Key Points

  • Naegleria fowleri
    • Protozoa
    • Disease
      • Rapidly fatal meningoencephalitis
        • Meninges + encephalitis = meningoencephalitis
        • “Brain eating amoeba”
      • Disease
        • Presentation very similar to meningitis: must do a CSF test
        • Inability to bend neck forward / nuchal rigidity
        • altered mental status
        • photophobia
        • sudden headache
        • altered sense of taste or smell
        • nose bleeds
    • Transmission/Risk factors
      • Swimming in warm freshwater (e.g. a lake)
        • Not acquired through drinking water, only by aspirating into nose
          • Enters via cribriform plate
    • Diagnosis
      • Amoebas in CSF
        • Elevated opening pressure
      • Culture and direct fluorescence antibody stain
        • Culture on E. coli lawn
      • Brain CT
        • Destruction of cisternae and subarachnoid spaces
    • Treatment/Prognosis
      • Amphotericin B has been effective for a few survivors
      • Fatal in majority of cases within 1 week
        • >95% fatality, even with treatment