RESUMO
We report the first case of primary amoebic meningoencephalitis in a 9-year-old boy in Guadeloupe. The outcome was rapidly fatal in 7 days. The patient presumably acquired the infection by swimming and diving in a basin supplied by natural thermal water 1 week before onset of the disease. The possibility of a free-living amoeba infection was suspected both on the negativity of all bacterial and viral initial tests and on the observation of peculiar cells in stained cerebrospinal fluid samples. Although the amoeba was not isolated, Naegleria fowleri could be identified by polymerase chain reaction with specific primers on DNA extracted from frozen cerebrospinal fluid samples. Furthermore, as the internal transcribed spacer (ITS1) region of DNA is variable in length between the different strains of N. fowleri, sequencing of the amplified ITS1 demonstrated that the responsible N. fowleri strain belongs to a common genotype present in the American and European continent.
Assuntos
Infecções Protozoárias do Sistema Nervoso Central/parasitologia , DNA de Protozoário/líquido cefalorraquidiano , Meningoencefalite/parasitologia , Naegleria fowleri/genética , Sequência de Bases , Infecções Protozoárias do Sistema Nervoso Central/líquido cefalorraquidiano , Criança , DNA de Protozoário/química , Evolução Fatal , Genótipo , Guadalupe , Humanos , Masculino , Meningoencefalite/líquido cefalorraquidiano , Dados de Sequência MolecularRESUMO
Five Naegleria strains isolated from patients with primary amebic meningoencephalitis and one strain isolated from the water of an artificial canal were investigated. All strains were pathogenic for mice when instilled intranasally and showed cytopathic effects in Vero cell cultures. Their growth characteristics (isolation and subculture at 45 degrees C), serological results, and isoenzyme patterns permitted us to identify the six strains as Naegleria fowleri. This is the first time that Naegleria fowleri has been isolated from patients with primary amebic meningoencephalitis in Mexico.
Assuntos
Amebíase/epidemiologia , Meningoencefalite/etiologia , Naegleria fowleri , Fosfatase Ácida/análise , Adolescente , Animais , Hidrolases de Éster Carboxílico/análise , Criança , Água Doce , Humanos , Lactente , Isoenzimas/análise , México/epidemiologia , Camundongos , Naegleria fowleri/enzimologia , Naegleria fowleri/isolamento & purificação , Naegleria fowleri/patogenicidade , Células Vero , Virulência , Microbiologia da ÁguaRESUMO
A 13 year old boy died after a three day illness with severe headache, explosive vomiting, fever and progressive loss of consciousness. The autopsy revealed purulent and necrotizing meningoencephalitis mainly involving the basal regions and posterior fossa and on microscopic examination numerous trophozoites of Naegleria were seen in the meninges and necrotic brain tissue. The trophozoites were identified as Naegleria fowleri by immunoperoxidase staining. This case as well as others previously reported in Mexico and the documented presence of Naegleria species from several sources indicate that primary amebic meningoencephalitis should be considered in the differential diagnosis of cases with neurological symptoms of sudden onset.
Assuntos
Amebíase , Meningoencefalite/patologia , Adolescente , Animais , Autopsia , Humanos , Masculino , Meningoencefalite/etiologia , Meningoencefalite/parasitologia , México , Naegleria/isolamento & purificaçãoRESUMO
Primary meningoencephalitis caused by Naegleria fowleri was documented in a 16-year-old male from Mexicali in the state of Baja California in Mexico. In August 1978, seven days after sustaining moderate head trauma while swimming in a shallow, stagnant irrigation ditch on a hot summer day, the patient presented an acute illness with severe headache, fever and convulsions rapidly progressing into a comatose state. Actively moving trophozoites were observed in the spinal fluid on admission. The patient died shortly after admission to hospital on the third day of symptoms. Post-mortem examination revealed a meningoencephalitis with extensive destruction, haemorrhage and numerous parasites involving structures of the posterior fossa. Immunoperoxidase strains of trophozoites in meningeal and cerebellar tissue were positive for N. fowleri KUL and negative for N. gruberi, N. australiensis and Acanthamoeba rhysodes. This appears to be the first documented case of the disease in Mexico.