Thursday, February 2, 2012

Amebic parasite kills two in Louisiana

Two deaths in Louisiana reported in The Advocate due to Naegleria fowleri contracted from using a Neti pot with tap water.

Naegleria fowleri
Naegleria fowleri

These deaths occurred in 2011 when the victims used tap water to irrigate their sinuses with a Neti pot and the organism gained access via their sinuses to the olfactory mucosa,  olfactory nerves and cribriform plate.

This almost always fatal brain infection,  primary amoebic meningoencephalitis (PAM), is fortunately rare.  Less than 1% who contract this protozoan infection in the brain recover.  Grim odds.

Contracting this organism via a neti pot is an unusual route of infection.  It more often gains entry via the nasal passages from swimming and diving in warm lakes, ponds and even heated swimming pools.

Diagnostic measures using real time PCR (polymerase chain reaction) are in the works.  Currently the organism is definitively diagnosed through clinical history and identifying the organism visually in CSF or brain tissue.

There is not effective accepted treatment of this protozoa, though Amphotericin B and sulfadiazine have been used though without promising results.

Naegleria fowleri transmission cycle

N. fowleri route of infection

1 comment:

  1. This illness is back in the news as two new deaths have been reported. One was from a whitewater training center and the other in a freshwater pond. The second patient was the child of an epidemiologist who theorizes that this illness is not as rare as one might expect due to misdiagnosis. How can this illness be prevented and how is the diagnosis made specifically? (You mentioned it diagnosed by history, but specifically what do we look for? What is the differential diagnosis?)