Primary amebic meningoencephalitis - Revision history

Danbot: Danbot moved page Primary Amebic Meningoencephalitis to Primary amebic meningoencephalitis without leaving a redirect: Naming convention: first word capitalized, subsequent words lowercase

2026-03-22T05:33:51Z

Danbot moved page Primary Amebic Meningoencephalitis to Primary amebic meningoencephalitis without leaving a redirect: Naming convention: first word capitalized, subsequent words lowercase

← Older revision	Revision as of 05:33, 22 March 2026
(No difference)

ClaireLewis at 17:47, 25 October 2020

2020-10-25T17:47:28Z

← Older revision		Revision as of 17:47, 25 October 2020
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	*[[Fever]]		*[[Fever]]
	*[[Headache]]		*[[Headache]]
	*[[Meningismus]]		*[[meningitis\|Meningismus]]
	*[[AMS]]		*[[AMS]]
	*[[Nausea]]		*[[Nausea]]
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	**Culture		**Culture
	*PCR of CSF or tissue sample are newer modalities		*PCR of CSF or tissue sample are newer modalities
	*~~Brain~~ CT - should be to evaluate for abscess/mass/hemorrhage and prior to LP		*[[CT brain]] - should be to evaluate for abscess/mass/hemorrhage and prior to LP

	==Management<ref>Linam et al. Successful Treatment of an Adolescent With ''Naegleria fowleri'' Primary Amebic Meningoencephalitis. Pediatrics. 2015;135(3):e744-e748.</ref><ref>Cope et al. Use of the Novel Therapeutic Agent Miltefosine for the Treatment of Primary Amebic Meningoencephalitis: Report of 1 Fatal and 1 Surviving Case. CID. 2016;62(6):774-776.</ref>==		==Management<ref>Linam et al. Successful Treatment of an Adolescent With ''Naegleria fowleri'' Primary Amebic Meningoencephalitis. Pediatrics. 2015;135(3):e744-e748.</ref><ref>Cope et al. Use of the Novel Therapeutic Agent Miltefosine for the Treatment of Primary Amebic Meningoencephalitis: Report of 1 Fatal and 1 Surviving Case. CID. 2016;62(6):774-776.</ref>==
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	**[[Miltefosine]]: 50mg PO BID (<45kg) or TID (>45kg) for 28 days		**[[Miltefosine]]: 50mg PO BID (<45kg) or TID (>45kg) for 28 days
	*[[Dexamethasone]]: 0.6mg/kg/day IV for 4 days		*[[Dexamethasone]]: 0.6mg/kg/day IV for 4 days
	*Therapeutic hypothermia		*[[Therapeutic hypothermia]]
	*Elevated ICP management		*[[Elevated ICP]] management
	**Hyperosmolar therapy ([[hypertonic saline]], [[mannitol]])		**Hyperosmolar therapy ([[hypertonic saline]], [[mannitol]])
	**EVD placement		**EVD placement
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	==References==		==References==
	<references/>		<references/>
			[[Category:ID]]
			[[Category:Neurology]]

Fredvarone at 22:18, 4 August 2020

2020-08-04T22:18:12Z

← Older revision		Revision as of 22:18, 4 August 2020
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	==See Also==		==See Also==


			==External Links==
	*https://www.cdc.gov/parasites/naegleria/health_professionals.html#one		*https://www.cdc.gov/parasites/naegleria/health_professionals.html#one
	*https://www.cdc.gov/parasites/naegleria/treatment-hcp.html		*https://www.cdc.gov/parasites/naegleria/treatment-hcp.html

	~~==External Links==~~


	==References==		==References==
	<references/>		<references/>

Fredvarone: Created page with "==Background== Primary amebic meningoencephalitis is a rare central nervous system disease caused by the thermophilic free-living amoeba ''Naegleria fowleri'' The amoeba liv..."

2020-08-04T22:17:44Z

Created page with "==Background== *Primary amebic meningoencephalitis is a rare central nervous system disease caused by the thermophilic free-living amoeba ''Naegleria fowleri'' *The amoeba liv..."

New page

==Background==
*Primary amebic meningoencephalitis is a rare central nervous system disease caused by the thermophilic free-living amoeba ''Naegleria fowleri''
*The amoeba lives in freshwater and can enter the brain through the cribriform plate after water containing it enters the nose; the amoeba causes direct tissue damage with hemorrhage and necrosis of brain tissue <ref>Marciano-Cabral F et al. The immune response to ''Naegleria fowleri'' amebae and
pathogenesis of infection. FEMS Immunol Med Microbiol. 2007;51(2):243-259.</ref>
*Exposure can occur from natural water sources (lakes, ponds, puddles) as well as man-made sources (swimming pools)
*Cases nearly always result in death - in the USA 141/145 known cases were fatal
*>50% cases in the USA occur in Texas and Florida<ref>Yoder JS et al. The epidemiology of primary amoebic meningoencephalitis in the USA, 1962–2008. Epidemiol Infect. 2010;138:968-975.</ref><ref>Gharpure R et al. Epidemiology and Clinical Characteristics of Primary Amebic Meningoencephalitis Caused by ''Naegleria fowleri'': A Global Review. CID. 2019. https://doi.org/10.1093/cid/ciaa520.</ref>

==Clinical Features==
*[[Fever]]
*[[Headache]]
*[[Meningismus]]
*[[AMS]]
*[[Nausea]]
*[[Vomiting]]
*[[Seizures]]
*[[Cranial nerve abnormalities]]
*[[Coma]]

==Differential Diagnosis==
*[[Encephalitis]]
*[[Meningitis]]
*[[Brain abscess]]
*[[Sepsis]]

==Evaluation==
*Often diagnosed post-mortem given general low clinical suspicion and rapid death of patients
*[[Lumbar puncture]] - basic studies may be consistent with meningitis with a negative Gram stain
**Wet mount may see free moving trophozoites
**Giemsa-Wright, H+E, PAS, trichrome staining may show amoebae
**Immunohistochemical staining
**Culture
*PCR of CSF or tissue sample are newer modalities
*Brain CT - should be to evaluate for abscess/mass/hemorrhage and prior to LP

==Management<ref>Linam et al. Successful Treatment of an Adolescent With ''Naegleria fowleri'' Primary Amebic Meningoencephalitis. Pediatrics. 2015;135(3):e744-e748.</ref><ref>Cope et al. Use of the Novel Therapeutic Agent Miltefosine for the Treatment of Primary Amebic Meningoencephalitis: Report of 1 Fatal and 1 Surviving Case. CID. 2016;62(6):774-776.</ref>==
*Anti-amoeba therapy (CDC recommendations at: https://www.cdc.gov/parasites/naegleria/treatment-hcp.html)
**[[Amphotericin B]]: 1.5mg/kg/day divided in 2 doses for 3 days followed by 1mg/kg/day IV as one dose for 11 days
**Intrathecal [[Amphotericin B]]: 1.5mg once daily for 2 days followed by 1mg/day every other day for 8 days
**[[Azithromycin]]: 10mg/kg/day once daily IV/PO for 28 days, max dose 500mg/day
**[[Fluconazole]]: 10mg/kg/day once daily IV/PO for 28 days, max dose 600mg/day
**[[Rifampin]]: 10mg/kg/day once daily IV/PO for 28 days, max dose 500mg/day
**[[Miltefosine]]: 50mg PO BID (<45kg) or TID (>45kg) for 28 days
*[[Dexamethasone]]: 0.6mg/kg/day IV for 4 days
*Therapeutic hypothermia
*Elevated ICP management
**Hyperosmolar therapy ([[hypertonic saline]], [[mannitol]])
**EVD placement
**CSF removal
*Infectious disease consultation

==Disposition==
*Admission to ICU
*Very few patients have made a full neurologic recovery; key factors are high clinical suspicion and prompt diagnosis, aggressive anti-amoeba therapy, and management of elevated ICP

==See Also==
*https://www.cdc.gov/parasites/naegleria/health_professionals.html#one
*https://www.cdc.gov/parasites/naegleria/treatment-hcp.html

==External Links==

==References==
<references/>

Primary amebic meningoencephalitis - Revision history

Danbot: Danbot moved page Primary Amebic Meningoencephalitis to Primary amebic meningoencephalitis without leaving a redirect: Naming convention: first word capitalized, subsequent words lowercase

ClaireLewis at 17:47, 25 October 2020

Fredvarone at 22:18, 4 August 2020

Fredvarone: Created page with "==Background== *Primary amebic meningoencephalitis is a rare central nervous system disease caused by the thermophilic free-living amoeba ''Naegleria fowleri'' *The amoeba liv..."

Fredvarone: Created page with "==Background== Primary amebic meningoencephalitis is a rare central nervous system disease caused by the thermophilic free-living amoeba ''Naegleria fowleri'' The amoeba liv..."