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A case report: primary amoebic meningoencephalitis in a young Zambian adult

BACKGROUND: Primary amoebic meningoencephalitis (PAM) is a fulminant disease of the brain caused by Naegleria fowleri. Although the disease is rare, the case fatality rate is very high. In this report, we describe the first case of PAM in Zambia. CASE PRESENTATION: The patient presented with sudden...

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Autores principales: Chomba, Mashina, Mucheleng’anga, Luchenga A., Fwoloshi, Sombo, Ngulube, Joseph, Mutengo, Mable M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5540533/
https://www.ncbi.nlm.nih.gov/pubmed/28764655
http://dx.doi.org/10.1186/s12879-017-2638-8
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author Chomba, Mashina
Mucheleng’anga, Luchenga A.
Fwoloshi, Sombo
Ngulube, Joseph
Mutengo, Mable M.
author_facet Chomba, Mashina
Mucheleng’anga, Luchenga A.
Fwoloshi, Sombo
Ngulube, Joseph
Mutengo, Mable M.
author_sort Chomba, Mashina
collection PubMed
description BACKGROUND: Primary amoebic meningoencephalitis (PAM) is a fulminant disease of the brain caused by Naegleria fowleri. Although the disease is rare, the case fatality rate is very high. In this report, we describe the first case of PAM in Zambia. CASE PRESENTATION: The patient presented with sudden onset of seizures and fever on admission. On physical examination he was febrile, comatose and with a stiff neck. Cerebral spinal fluid (CSF) collected on admission did not reveal any organism on microscopy or culture but showed elevated white cell count. A working diagnosis of severe septicemia with acute meningoencephalitis was then made and the patient was started on IV Cephtriaxone (2 g) twice daily. Despite receiving treatment, his condition deteriorated. A second CSF sample collected on day 3 was also negative for bacteria and other organisms. However, a repeat CSF sample collected on day 8 revealed numerous motile organisms that were identified as Naegleria on microscopy and confirmed to be N. fowleri on polymerase chain reaction. The patient died on day 8 of hospital admission after having received one dose of Amphotericin B (50 mg). Features consistent with PAM were detected on autopsy. CONCLUSION: The isolation of N. fowleri in this patient calls for increased awareness among clinical and laboratory staff on suspected PAM cases to promptly diagnose and effectively manage the disease. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12879-017-2638-8) contains supplementary material, which is available to authorized users.
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spelling pubmed-55405332017-08-07 A case report: primary amoebic meningoencephalitis in a young Zambian adult Chomba, Mashina Mucheleng’anga, Luchenga A. Fwoloshi, Sombo Ngulube, Joseph Mutengo, Mable M. BMC Infect Dis Case Report BACKGROUND: Primary amoebic meningoencephalitis (PAM) is a fulminant disease of the brain caused by Naegleria fowleri. Although the disease is rare, the case fatality rate is very high. In this report, we describe the first case of PAM in Zambia. CASE PRESENTATION: The patient presented with sudden onset of seizures and fever on admission. On physical examination he was febrile, comatose and with a stiff neck. Cerebral spinal fluid (CSF) collected on admission did not reveal any organism on microscopy or culture but showed elevated white cell count. A working diagnosis of severe septicemia with acute meningoencephalitis was then made and the patient was started on IV Cephtriaxone (2 g) twice daily. Despite receiving treatment, his condition deteriorated. A second CSF sample collected on day 3 was also negative for bacteria and other organisms. However, a repeat CSF sample collected on day 8 revealed numerous motile organisms that were identified as Naegleria on microscopy and confirmed to be N. fowleri on polymerase chain reaction. The patient died on day 8 of hospital admission after having received one dose of Amphotericin B (50 mg). Features consistent with PAM were detected on autopsy. CONCLUSION: The isolation of N. fowleri in this patient calls for increased awareness among clinical and laboratory staff on suspected PAM cases to promptly diagnose and effectively manage the disease. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12879-017-2638-8) contains supplementary material, which is available to authorized users. BioMed Central 2017-08-01 /pmc/articles/PMC5540533/ /pubmed/28764655 http://dx.doi.org/10.1186/s12879-017-2638-8 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Case Report
Chomba, Mashina
Mucheleng’anga, Luchenga A.
Fwoloshi, Sombo
Ngulube, Joseph
Mutengo, Mable M.
A case report: primary amoebic meningoencephalitis in a young Zambian adult
title A case report: primary amoebic meningoencephalitis in a young Zambian adult
title_full A case report: primary amoebic meningoencephalitis in a young Zambian adult
title_fullStr A case report: primary amoebic meningoencephalitis in a young Zambian adult
title_full_unstemmed A case report: primary amoebic meningoencephalitis in a young Zambian adult
title_short A case report: primary amoebic meningoencephalitis in a young Zambian adult
title_sort case report: primary amoebic meningoencephalitis in a young zambian adult
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5540533/
https://www.ncbi.nlm.nih.gov/pubmed/28764655
http://dx.doi.org/10.1186/s12879-017-2638-8
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