title: Primary amebic meningoencephalitis: a case report and literature review.
abstract: Primary amebic meningoencephalitis (PAM) is a rare but nearly always fatal disease caused by infection with Naegleria fowleri, a thermophilic, free-living ameba found in freshwater environments. Cases of N. fowleri infection have been reported from many of the southern-tier states in the United States, with Florida and Texas disproportionately represented among them. Primary amebic meningoencephalitis presents clinically in a fashion that may be indistinguishable from bacterial and viral meningitis. Unfortunately, because the disease is so rare, PAM is often excluded from the differential diagnosis of children with meningitis resulting in delayed diagnostic and therapeutic efforts.Pediatric acute care practitioners in emergency departments, general pediatric wards, and critical care units, especially those practicing in the southern United States, should be familiar with the risk factors for acquisition of PAM, its clinical presentation, and the fact that common empiric treatment of bacterial meningitis will not treat N. fowleri. 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 nervous system.
authors.affiliation: University of Florida, Jacksonville, FL, USA.
authors.forename: Christina
authors.initials: C
authors.lastname: Lopez
authors.forename: Phillip
authors.initials: P
authors.lastname: Budge
authors.forename: Jimmy
authors.initials: J
authors.lastname: Chen
authors.forename: Suzanne
authors.initials: S
authors.lastname: Bilyeu
authors.forename: Ayesha
authors.initials: A
authors.lastname: Mirza
authors.forename: Haidee
authors.initials: H
authors.lastname: Custodio
authors.forename: Jose
authors.initials: J
authors.lastname: Irazuzta
authors.forename: Govinda
authors.initials: G
authors.lastname: Visvesvara
authors.forename: Kevin J
authors.initials: KJ
authors.lastname: Sullivan
mesh_terms: D000293:Adolescent; D000562:Amebiasis / Q000175:diagnosis* / Q000382:microbiology / Q000503:physiopathology / Q000628:therapy; D020808:Central Nervous System Protozoal Infections / Q000175:diagnosis* / Q000382:microbiology / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D008297:Male; D016848:Naegleria fowleri / Q000302:isolation & purification*