Presentation
Primary amebic meningoencephalitis presents clinically in a fashion that may be indistinguishable from bacterial and viral meningitis. [ncbi.nlm.nih.gov]
Photophobia may also be present. There can still be a successful outcome when a patient presents with lethargy/somnolence, considered to be one of the "late" signs. [orlandomedicalnews.com]
Entire Body System
- Fever
Am Fam Physician. 2016 Apr 15;93(8):644. to the editor : When seeing patients with headache and fever, particularly in warmer months, physicians in the United States should consider the diagnosis of primary amebic meningoencephalitis (PAM). [aafp.org]
In August 2007, a boy aged 12 years was admitted to a hospital with a 6-day history of fever. His mother reported her son had become disoriented and lethargic. [cdc.gov]
The illness begins suddenly with the abrupt onset of fever, headache, nausea, and vomiting. [ncbi.nlm.nih.gov]
Health topics A - Z Health topics by body part Health conditions, prevention and treatment Abortions Alcohol Assisted insemination Asthma and hay fever Bites, burns, cuts and pests Blood, organ and tissue Cancer Challenging behaviour Chemicals and contaminants [sahealth.sa.gov.au]
- Hypothermia
Strategies to reduce intracranial pressure include: steroids, CSF drainage, hyperventilation, hyperosmolar therapy, mannitol, and hypothermia. 1, 2 Currently, only three states specifically require reporting of PAM cases (Florida, Louisiana, and Texas [aafp.org]
This report is also the first to document successful use of induced hypothermia (32°C–34°C) in the management of PAM. [pediatrics.aappublications.org]
Her recovery has been attributed to early diagnosis and treatment and novel therapeutics including miltefosine and hypothermia 7. [cdc.gov]
He did not receive therapeutic hypothermia treatment. Overall, the outlook for those who get this disease is poor, although early diagnosis and new types of treatments may increase a person's chances of survival. [disabled-world.com]
- Severe Pain
As for the stiff neck, Bell said it would be “so severe that you can’t bend your head forward and touch your chin to your chest without causing severe pain.” [islandpacket.com]
Respiratoric
- Aspiration
She performed handstands under water, got water up her nose, and swallowed or aspirated water multiple times. Her parents and 2 brothers swam at the same locations, but no one else in the family became ill. [doi.org]
- Rhinorrhea
There was no history of exposure to pond water or swimming prior to the infection but probably the patient was harboring the pathogens in the nose since a long time and CSF rhinorrhea predisposed the patient to PAM. [ncbi.nlm.nih.gov]
- Pertussis
Pertussis information from the Minnesota Department of Health. [co.washington.mn.us]
Gastrointestinal
- Vomiting
The symptoms include headache, nausea, rigidity of the neck muscles, vomiting, delirium, seizures and coma. primary amebic menencephalitis naegleriasis amebic encephalitis PAM naegleria infection Naegleria fowleri infection Primary Amoebic Meningoencephalitis [wikidata.org]
On June 17, 2015, a previously healthy woman aged 21 years went to an emergency department after onset of headache, nausea, and vomiting during the preceding 24 hours. [ncbi.nlm.nih.gov]
His kidneys stabilized and other symptoms like headache and vomiting gradually receded. By the end of the 3rd week, he was declared fit to leave the hospital. “Initially, it seemed like meningitis. [tlarremore.wordpress.com]
- Nausea
The symptoms include headache, nausea, rigidity of the neck muscles, vomiting, delirium, seizures and coma. primary amebic menencephalitis naegleriasis amebic encephalitis PAM naegleria infection Naegleria fowleri infection Primary Amoebic Meningoencephalitis [wikidata.org]
On June 17, 2015, a previously healthy woman aged 21 years went to an emergency department after onset of headache, nausea, and vomiting during the preceding 24 hours. [ncbi.nlm.nih.gov]
Primary amebic meningoencephalitis can progress rapidly from changes in smell or taste, headaches, a stiff neck, nausea, and vomiting to confusion and death. [msdmanuals.com]
Most common early symptoms: Headache (usually severe, sudden-onset), fever, nausea/vomiting. Photophobia may also be present. [orlandomedicalnews.com]
Skin
- Flushing
Ways to help reduce the risk include: ensuring swimming pools are chlorinated and well maintained avoiding getting water up the nose in fresh water lakes and pools flush out old water before allowing children to play with hoses or sprinklers use fresh [healthdirect.gov.au]
[…] bodies of warm fresh water or thermal pools keep your head above water in spas, thermal pools and warm fresh water bodies empty and clean small collapsible wading pools daily ensure swimming pools and spas are adequately chlorinated and well maintained flush [conditions.health.qld.gov.au]
If the water in a hose or sprinkler remains warm even after flushing for a few minutes, do not let children play with it. Let bath and shower taps run for a few minutes to flush out the pipes. [healthywa.wa.gov.au]
[…] boy who presented with meningoencephalitis. 4, 5 Pathophysiology N. fowleri lives and multiplies in warm freshwater areas, and acquisition is often associated with water-based recreational activities. 6 Infection may occur when contaminated water is flushed [mja.com.au]
Eyes
- Photophobia
Upon evaluation, she was vomiting profusely and had photophobia and nuchal rigidity. Analysis of cerebrospinal fluid was consistent with meningitis.* She was empirically treated for bacterial and viral meningoencephalitis. [ncbi.nlm.nih.gov]
Photophobia may also be present. There can still be a successful outcome when a patient presents with lethargy/somnolence, considered to be one of the "late" signs. [orlandomedicalnews.com]
It presents similarly to a severe and highly aggressive bacterial meningoencephalitis, with common clinical features including severe headache, high fever, nuchal rigidity, nausea, vomiting, photophobia, cranial nerve palsies, change in mental status, [radiopaedia.org]
[…] progression other symptoms include lethargy, confusion, and stiff neck; convulsions may occur with rapid deterioration to coma and death within 1- 14 days; other symptomsinclude abnormalities of taste and smell, seizures, cerebellar ataxia, nuchal rigidity, photophobia [msdsonline.com]
Symptoms such as severe headache, high grade fever, photophobia, lethargy, confusion with altered levels of consciousness and seizures are commonly observed in patients with PAM. [bmcinfectdis.biomedcentral.com]
Neurologic
- Headache
Am Fam Physician. 2016 Apr 15;93(8):644. to the editor : When seeing patients with headache and fever, particularly in warmer months, physicians in the United States should consider the diagnosis of primary amebic meningoencephalitis (PAM). [aafp.org]
The symptoms include headache, nausea, rigidity of the neck muscles, vomiting, delirium, seizures and coma. primary amebic menencephalitis naegleriasis amebic encephalitis PAM naegleria infection Naegleria fowleri infection Primary Amoebic Meningoencephalitis [wikidata.org]
On November 16, 2012, the patient had visited the emergency department with a headache; he was treated symptomatically and released. [ncbi.nlm.nih.gov]
On September 2, 2007, a boy aged 10 years was evaluated in a local ED for headache, body aches, high fever, nausea, vomiting, and fainting. His symptoms had begun on August 31 with headache and lethargy. [cdc.gov]
- Seizure
METHODS AND RESULTS We describe two children, aged four and 14 years, who both presented with seizures and altered mental status after recent fresh water swimming exposures. [unboundmedicine.com]
The symptoms include headache, nausea, rigidity of the neck muscles, vomiting, delirium, seizures and coma. primary amebic menencephalitis naegleriasis amebic encephalitis PAM naegleria infection Naegleria fowleri infection Primary Amoebic Meningoencephalitis [wikidata.org]
We describe two children, aged four and 14 years, who both presented with seizures and altered mental status after recent fresh water swimming exposures. [ncbi.nlm.nih.gov]
Treat the infection with multiple antimicrobial drugs, including miltefosine; if needed, treat seizures and cerebral edema with antiseizure drugs and dexamethasone. Click here for Patient Education NOTE: This is the Professional Version. [msdmanuals.com]
- Confusion
The following day, the patient returned to the emergency department by ambulance with fever, confusion, agitation, and a severe headache, for which he was admitted. [ncbi.nlm.nih.gov]
They may become confused and sleepy and may have seizures. The infection can progress rapidly, causing death within 10 days. [msdmanuals.com]
- Altered Mental Status
We describe two children, aged four and 14 years, who both presented with seizures and altered mental status after recent fresh water swimming exposures. [ncbi.nlm.nih.gov]
METHODS AND RESULTS We describe two children, aged four and 14 years, who both presented with seizures and altered mental status after recent fresh water swimming exposures. [unboundmedicine.com]
Initial symptoms include severe frontal headache, fever, nausea, and vomiting followed by stiff neck, seizures, altered mental status, hallucinations, and coma. There have been 4 known survivors in North America. [tlarremore.wordpress.com]
Later stage symptoms include a stiff neck, seizures, altered mental status, hallucinations and coma, according to the agency. Some of those symptoms might almost sound commonplace, but they’re not. [islandpacket.com]
- Lethargy
Headache, lethargy and coma developed in this patient, and her condition progressed to death 8 days after the onset of clinical symptoms. [ncbi.nlm.nih.gov]
There can still be a successful outcome when a patient presents with lethargy/somnolence, considered to be one of the "late" signs. [orlandomedicalnews.com]
Blood 2012 119:3658; doi: https://doi.org/10.1182/blood-2011-06-353136 A 7-year-old boy with no prior illness or altered immunity presented to the emergency department with a 36-hour history of fever (103.7°F), emesis, headache, and lethargy. [doi.org]
Workup
(See Presentation, Workup, Treatment, and Medication.) Linam et al presented a survivor of amebic meningoencephalitis in North America. [emedicine.medscape.com]
Serum
- Hypoglycemia
He was given dextrose 25% 50 ml to treat suspected hypoglycemia prior to shifting to our hospital casualty and the Random blood sugar (RBS) at presentation was 426 mg/dl. [ncbi.nlm.nih.gov]
Treatment
[…] infection, you are urged to call the CDC's 24/7 emergency consultation telephone number (770-488-7100) for diagnostic and treatment recommendations. [aafp.org]
Time is of the essence in treatment initiation. Most common early symptoms: Headache (usually severe, sudden-onset), fever, nausea/vomiting. Photophobia may also be present. [orlandomedicalnews.com]
Recovery is rare and depends on rapid diagnosis and treatment. [ncbi.nlm.nih.gov]
Her recovery has been attributed to early diagnosis and treatment and novel therapeutics including miltefosine and hypothermia 5. [cdc.gov]
Prognosis
The infection is usually difficult to diagnose and has a poor prognosis. The present case is one such case in which CSF examination led us to the diagnosis of PAM and finally to a favorable outcome when treated with Amphoterracin B and antibiotics. [ncbi.nlm.nih.gov]
Prognosis is often very poor even with treatment 1-3 . [radiopaedia.org]
In conclusion, although PAM is a rare disease with poor prognosis, it should be considered in differential diagnosis of bacterial meningitis specially when CSF smear and culture is negative and patient has a history of contact with contaminated fresh [pjms.com.pk]
Primary amoebic meningoencephalitis (PAM) is a rare but fulminant disease leading to diffuse haemorrhagic necrotising meningoencephalitis, and has a very poor prognosis. 1 Naegleria fowleri is the causative agent. [mja.com.au]
Etiology
The etiological agent in most reported cases of PAM is the ameboflagellate Naegleria fowleri. Infection with this organism closely mimics and is often mistaken for a bacterial or a viral pyogenic meningitis. [ncbi.nlm.nih.gov]
It is suggested that in these 3 cases there may be a common etiologic pattern of intranasal inoculation resulting from prolonged swimming in tepid lake water.Pathological findings in the first 2 cases were presented to the 1964 Scientific Session of the [doi.org]
Epidemiology
This report summarizes clinical and epidemiologic information about these two cases and characterizes N. fowleri infection. [ncbi.nlm.nih.gov]
Standardized surveillance and reporting of amebic encephalitis, including PAM, is crucial to understanding the changing epidemiology. [cste.org]
Weekly Epidemiological Record = Relevé épidémiologique hebdomadaire, 58 (34), 257 - 258. https://apps.who.int/iris/handle/10665/224608 Revista Weekly Epidemiological Record = Relevé épidémiologique hebdomadaire, 58 (34): 257 - 258 [apps.who.int]
Pathophysiology
Herein, we present the case of an adolescent who died of PAM and review the (a) epidemiology, (b) pathophysiology, (c) available diagnostic modalities, (d) treatment options, and (e) outcomes of patients treated for N. fowleri infection of the central [ncbi.nlm.nih.gov]
[…] greater awareness of disease or due to development of more rapid, highly sensitive and specific diagnostic tests. [3] About 300 cases have been reported so far with high case fatality rate of around 95%. [4] There has been advances in understanding of pathophysiology [ruralneuropractice.com]
Pathophysiology PAM can occur in previously healthy young individuals exposed to warm, especially stagnant, fresh water. [emedicine.medscape.com]
Following communication of his findings, Cooter and colleagues were able to directly observe the live amoeba in a CSF sample from a 10-year-old boy who presented with meningoencephalitis. 4, 5 Pathophysiology N. fowleri lives and multiplies in warm freshwater [mja.com.au]
Prevention
Centers for Disease Control and Prevention. Naegleria fowleria – primary amebic meningoencephalitis (PAM) – amebic encephalitis. http://www.cdc.gov/parasites/naegleria/treatment-hcp.html. Accessed March 3, 2016. [aafp.org]
Review the Naegleria fowleri FAQ's from the Centers for Disease Control and Prevention. [acacamps.org]
The amoeba, Naegleria fowleri, usually enters the body through the nose, and the organism inhabits freshwater, according to the Centers for Disease Control and Prevention. [nbcnews.com]
Health topics A - Z Health topics by body part Health conditions, prevention and treatment Abortions Alcohol Assisted insemination Asthma and hay fever Bites, burns, cuts and pests Blood, organ and tissue Cancer Challenging behaviour Chemicals and contaminants [sahealth.sa.gov.au]