Post on 15-Aug-2015
transcript
PRIMARY AMOEBIC MENINGOENCEPHALITIS CAUSED BY NAEGLERIA FOWLERI, KARACHI, PAKISTAN
PRESENTED BY :DARAKHSHAN SALEEMMS MICROBIOLOGYFUUASTE
Brain-Eating Amoeba
Brain-Eating Amoeba
So-called Brain-eating amoeba is a species
discovered in 1965.
There are several species of Naegleria but only
the fowleri species causes human disease.
Naegleria loves very warm water. It can
survive in water as hot as 113 degrees
Fahrenheit.
N. fowleri amoebas are relatively common, they only
rarely cause brain disease.
N. fowleri disease is known as Primary Amoebic
Meningoencephalitis (PAM).
It occurs from zero to eight times a year, almost
always from July to September
SYMPTOMS :
Headache
fever
stiff neck
loss of appetite
vomiting
altered mental state
seizures
comaThere may also be hallucinations, drooping eyelid, blurred vision, and loss of the sense of taste.
Two cases were studied at AKUH
In June 2008
•2 DAYS HISTORY
•HGF
•SEIZURES
•COMATOSE WITH FIXED AND DIALATED LEFT EYE PUPIL
CSF ANALYSIS IN BOTH CASES
• ELEVATED PROTEIN LEVEL
• ELEVATED NEUTROPHILIC PLEOCYTOSIS
• HYPOGLYCORRHACHIA
• GS AND LA WERE NEGATIVE
THOSE PATEINTS WERE TREATED WITH
AMPHOTERECIN B
RIFAMPIN,FLUCONAZOLNZOOLRIFA
MOITHEY WERE INCUBATED AND VANTILATED
AFTRE HOSPITAL ADMISSION
BUT NO ONE SURVIVED
BECAUSE…..GS AND LA WERE NEGATIVE
CSF CULTURED ON NON NUTRIENT AGAR ON A
LAWN OF E.COLI ,OBSERVED CULTURED
AMOEBA..WHICH LATER ON PRODUCED
FLAGELA
MOLECULAR DIAGNOSIS:
IN JUNE 2009 CSF COLLECTED FROM 3
PATIENTS AND CONFIRMED THE INFECTION
BY REAL TIME PCR
o Separation of DNA double-stranded template
o Primer formation
o Extension of new DNA strands by a DNA
polymerase and deoxyribonucleoside
triphosphates (dNTPs)
o Other proteins involved
PRINCIPLE
CONT….
PRIMER NaegF192 (3’-GTG CTG AAA CCT
AGC TAT TGT AAC TCA GT-5’) AND
NaegIR344 (5’-CAC TAG AAA AAG CAA
ACC TGA AAG G-3’) WERE USED TO
AMPLIFY A 153-bp FRAGMENT
• THIS WAS DETECTED BY
HEXACHLOROFLUORESCEIN(HEX)
LABELED PROBE Nfowl(5’-HEX-AT AGC
AAT ATA TTC AGG GGA GCT GGG C-
BHQ1-3’)
CONCLUSIONS
• PAM CASES INCREASE IN KARACHI AND MOST
PATIENTS WERE YOUNG HEALTHY ADULTS .
• PAM DIAGNOSIS SHOULD BE IMPROVE BUT
THIS IS NOT THE SOLE REASON
• PAM IS ASSOCIATED WITH FRESH WATER
SWIMMING POOL HAVING POORLY
CHLORINATED WATER