Thursday, July 14, 2011

Free Living

A young adult is rushed into the emergency department with acute onset headache, fever, neck stiffness, nausea, and vomiting. She notes that things taste and smell funny as well. Labs show a leukocytosis with elevated PMNs. A lumbar puncture has elevated opening pressure, PMN pleocytosis, increased protein, decreased glucose. She's started on appropriate antibiotics for bacterial meningitis, but she suffers progressive deterioration with seizures, ataxia, cranial nerve palsies, and confusion. Imaging shows cerebral edema, leptomeningeal enhancement, and areas of hemorrhage and necrosis. Finally, she falls into a coma and then dies. Lifecycle stages of the organisms recovered are shown above.

Challenge: How is this disease acquired?

Image is in the public domain.


toad said...

swimming in some boggy swamp. pristine, granite-bottomed, freezing cold alpine lakes are still worth jumping in! :P

Craig Chen said...

Free Living

Naegleria fowleri is a free-living amoeba that lives in warm bodies of freshwater (lakes, ponds, inadequately chlorinated pools). It enters the CNS via the olfactory epithelium, crossing the cribriform plate.

Sources: UpToDate; Wikipedia.