Naegleria fowleri is the only one species associated with human disease which causes primary amebic meningoencephalitis (PAM). It affects majorly the central nervous system (CNS) of infected individuals. Mostly, young adults, children and immunocompromised people (poor immunity) are easily susceptible to infection. Among the other species, Naegleria australiensis and Naegleria italic also associated with disease but in animals. Naegleriasis is an aquatic borne disease, so individuals who are all active in swimming, diving in polluted pools, contaminated health spa and environmental waterways are prone to free-living unicellular eukaryote Naegleria infection.(1)
Is There A Surgery For Naegleria Infection?
Naegleriasis does not require surgery. The mode is infection through contaminated water bodies. It infects the human system by entering through the nose when water forced into the nasal cavity. The onset of infection first began with trophozoites attachment to the nasal mucosa. Tasteless feelings and numbness in the head symptoms are due to infection in the nasal cavity. Later, it moves along the olfactory nerves and to reach the olfactory bulbs within the CNS.
Naegleriasis never spread from one person to another. Humans cannot get an infection from drinking contaminated water with Naegleria. They can only be infected when contaminated water goes up into your nose.(1)
Detection Of Naegleria Fowleri
Naegleria fowleri infection can be identified in the laboratory by detecting N. fowleri organisms in cerebrospinal fluid (CSF) or tissue specimens (biopsy). More recently, molecular techniques such as PCR and real-time PCR have been developed for the detection of N. fowleri in environmental and clinical samples
Current Treatment Options
Anti-microbial therapy is required for many days to treat the brain edema. To be effective, treatment should be started early, but until a drug with specific activity against the organism suitable for use by a parenteral route and with the ability to reach therapeutic levels in brain tissue is found, successful treatment is unlikely.
Drugs Used For Naegleriasis
Amphotericin B has a minimal amoebicidal concentration of 0.01 μg/ml against N. fowleri. In vitro studies have shown that an amphotericin B (intrathecal and intravenous amphotericin B) concentration of at least 0.1 μg/ml was needed to suppress greater than 90% of growth, while 0.39 μg/ml was needed to completely suppress amoeba proliferation. Other anti-infective which have been used in case reports include fluconazole, miconazole, miltefosine, azithromycin, and rifampin. Various other agents have been studied in vitro and in vivo, including hygromycin, rokitamycin, clarithromycin, erythromycin, roxithromycin, and zeocin. The CDC has made miltefosine available on a need basis through an investigational new drug (IND) protocol for the treatment of infections caused by free-living amoebas, which include N. fowleri, Balamuthia mandrillaris, and Acanthamoeba species.(2)
PAM caused by Naegleria fowleri is a rare disease. Even if they get an infection, the rate of survivability is very less. Up to date, there have been only seven survivors worldwide. According to the literature, millions of persons are exposed to the free-living amoeba but only a handful of them ever get sick from it. Antimicrobial therapy is helpful to some extent and surgery does not need for these cases. Hypothermia, such as cooling of the body below normal body temperature was not used.
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