The image shows a cyst, trophozoite, and flagellate. This organism is found in warm bodies of water like hot springs and man-made lakes and ponds; it is not seen in seawater. The typical presentation is a previously healthy child or adult with freshwater exposure in the last 2 weeks who presents with acute onset of headache, fever, neck stiffness, nausea, and vomiting. Uniquely, sense of smell and taste are affected. Antibiotics do not help, and patients then develop seizures, ataxia, cranial nerve palsies, confusion, and coma. This disease is fatal in 95% of cases within 4-6 days due to brain herniation.Challenge: What's the pathogen?
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Naegleria Fowleri?
The brain-eating amoeba: Naegleria fowleri!
Naegleria fowleri?
did the pateint have amoebic meningoencephalitis?
yep! scary
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Freshwater
Naegleria fowlerii is a free-living amoeba which causes an acute fulminant primary amebic meningoencephalitis. It accesses the CNS via the olfactory epithelium, traversing the cribriform plate to the brain. Labs show PMNs; CSF resembles bacterial meningitis; imaging shows cerebral edema, leptomeningeal enhancement, hemorrhage, and necrosis. Treatment is amphotericin B and rifampin.
Sources: UpToDate; Wikipedia.
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