Koray Oncel1, Leman Karaagac2, Hande Dagcı3, Mehmet Aykur4. 1. Microbiology Laboratory of Mehmet Akif İnan Education and Research Hospital, Sanlıurfa, Turkey. 2. Infection Diseases Department of Mehmet Akif İnan Education and Research Hospital, Sanlıurfa, Turkey. 3. Faculty of Medicine, Department of Parasitology, Ege University, Izmir, Turkey. 4. Faculty of Medicine, Department of Parasitology, Tokat Gaziosmanpasa University, Tokat, Turkey. mehmetaykur@gmail.com.
Abstract
BACKGROUND: Naegleria fowleri, the causative agent of primary amoebic meningoencephalitis (PAM), is a free-living amoeba. It is a water-borne infection usually detected in children and young people with healthy immune system who swim, dive and perform activities in fresh and hot springs. PURPOSE: In this study, it was aimed to raise awareness in the differential diagnosis of meningitis etiopathogenesis by showing that N. fowleri may also be the causative agent, albeit very rarely, in meningitis cases in Turkey. METHODS: Our case was an 18-year-old male patient whose relatives stated that he has gone to the hot spring; his headache complaint started after 2 to 3 days after return from the hot spring. Cerebrospinal fluid (CSF) sample taken from the patient was investigated by direct microscopic examination, real-time PCR method and sequence analysis. RESULTS: The CSF sample collected was taken into distilled water considering the possibility of transformation of trophozoites to intermediate form and incubated at 37 °C for 1 to 2 h, and pear-shaped non-permanent flagellated forms were observed in the direct microscopic examination, and molecular typing was performed to confirm the diagnosis. This study was a comprehensive case of N. fowleri whose etiological agent was isolated and confirmed by real-time PCR in Turkey. CONCLUSION: Clinician awareness would be the key factor in correctly diagnosing PAM. It is also recommended to investigate all likely environmental water sources in Turkey for more detailed information on the distribution and molecular identification of Naegleria species, ultimately to evaluate the potential pathogenic threat to human health and to develop strategies to combat such threats.
BACKGROUND: Naegleria fowleri, the causative agent of primary amoebic meningoencephalitis (PAM), is a free-living amoeba. It is a water-borne infection usually detected in children and young people with healthy immune system who swim, dive and perform activities in fresh and hot springs. PURPOSE: In this study, it was aimed to raise awareness in the differential diagnosis of meningitis etiopathogenesis by showing that N. fowleri may also be the causative agent, albeit very rarely, in meningitis cases in Turkey. METHODS: Our case was an 18-year-old male patient whose relatives stated that he has gone to the hot spring; his headache complaint started after 2 to 3 days after return from the hot spring. Cerebrospinal fluid (CSF) sample taken from the patient was investigated by direct microscopic examination, real-time PCR method and sequence analysis. RESULTS: The CSF sample collected was taken into distilled water considering the possibility of transformation of trophozoites to intermediate form and incubated at 37 °C for 1 to 2 h, and pear-shaped non-permanent flagellated forms were observed in the direct microscopic examination, and molecular typing was performed to confirm the diagnosis. This study was a comprehensive case of N. fowleri whose etiological agent was isolated and confirmed by real-time PCR in Turkey. CONCLUSION: Clinician awareness would be the key factor in correctly diagnosing PAM. It is also recommended to investigate all likely environmental water sources in Turkey for more detailed information on the distribution and molecular identification of Naegleria species, ultimately to evaluate the potential pathogenic threat to human health and to develop strategies to combat such threats.
Authors: María Reyes-Batlle; Aitor Rizo-Liendo; Rubén A Viera-Santana; Sara Afonso-Morales; Atteneri López-Arencibia; Ines Sifaoui; Olfa Chiboub; Carlos J Bethencourt-Estrella; Desirée San Nicolás-Hernández; Rubén L Rodríguez-Expósito; Jonadab Zamora-Herrera; Basilio Valladares; José E Piñero; Francisco J Díaz; Jacob Lorenzo-Morales Journal: Acta Parasitol Date: 2019-04-02 Impact factor: 1.440
Authors: Jia Xue; Frederica G Lamar; Bowen Zhang; Siyu Lin; Jennifer G Lamori; Samendra P Sherchan Journal: Sci Total Environ Date: 2017-12-13 Impact factor: 7.963