PRIMARY AMOEBIC
MENINGOENCEPHALITIS CAUSED
BY NAEGLERIA FOWLERI,
KARACHI, PAKISTAN
PRESENTED BY :DARAKHSHAN SALEEM
MS MICR...
Brain-Eating Amoeba
Brain-Eating Amoeba
 So-called Brain-eating amoeba is a species
discovered in 1965.
 There are sever...
 N. fowleri amoebas are relatively common, they only
rarely cause brain disease.
 N. fowleri disease is known as Primary...
SYMPTOMS :
Headache
fever
stiff neck
loss of appetite
vomiting
altered mental state
seizures
coma
There may also ...
Two cases were studied at AKUH
In June 2008
•2 DAYS HISTORY
•HGF
•SEIZURES
•COMATOSE WITH FIXED AND DIALATED
LEFT EYE PUPIL
IN SEPTEMBER 2008
PATEINT WAS 25 YEARS OLD
• 24 HRS HISTORY
• FEVER
• VOMITING
• NECK RIGIDITY
CSF ANALYSIS IN BOTH CASES
• ELEVATED PROTEIN LEVEL
• ELEVATED NEUTROPHILIC PLEOCYTOSIS
• HYPOGLYCORRHACHIA
• GS AND LA WE...
TILL APRIL2009 NO PAM DETECTED
IN APRIL 2009 THERE WERE 11
PATIENTS WITH PAM REFERRED TO
AKU
THOSE PATEINTS WERE TREATED WITH
AMPHOTERECIN B
RIFAMPIN,FLUCONAZOLNZOOLRIFA
MOITHEY WERE INCUBATED AND
VANTILATED AFTRE H...
BECAUSE…..GS AND LA WERE
NEGATIVE
CSF CULTURED ON NON NUTRIENT AGAR ON A
LAWN OF E.COLI ,OBSERVED CULTURED
AMOEBA..WHICH L...
ON THE BASIS OF THESE DIAGNOSIS
WET MOUNT DONE BY LAB
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 deo...
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-...
• THIS WAS DETECTED BY
HEXACHLOROFLUORESCEIN(HEX)
LABELED PROBE Nfowl(5’-HEX-AT AGC
AAT ATA TTC AGG GGA GCT GGG C-
BHQ1-3’)
PCR PERFORMANCE
2 INITIAL INCUBATIONS
AT 50 C WITH URACIL-DNA-
GLYCOSYLASE ACTIVITY FOR 2
MINS
2ND
AT 95 C WITH ACTIVATION
OF PLATINIUM Taq DNA
POLYMERASE)
FLOURESECNCE WAS MEASURED
CONCLUSIONS
• PAM CASES INCREASE IN KARACHI AND
MOST PATIENTS WERE YOUNG HEALTHY
ADULTS .
• PAM DIAGNOSIS SHOULD BE IMPROV...
NAEGLERIA
NAEGLERIA
NAEGLERIA
of 21

NAEGLERIA

case study
Published on: Mar 3, 2016
Published in: Health & Medicine      
Source: www.slideshare.net


Transcripts - NAEGLERIA

  • 1. PRIMARY AMOEBIC MENINGOENCEPHALITIS CAUSED BY NAEGLERIA FOWLERI, KARACHI, PAKISTAN PRESENTED BY :DARAKHSHAN SALEEM MS MICROBIOLOGY FUUASTE
  • 2. 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.
  • 3.  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
  • 4. SYMPTOMS : Headache fever stiff neck loss of appetite vomiting altered mental state seizures coma There may also be hallucinations, drooping eyelid, blurred vision, and loss of the sense of taste.
  • 5. Two cases were studied at AKUH In June 2008 •2 DAYS HISTORY •HGF •SEIZURES •COMATOSE WITH FIXED AND DIALATED LEFT EYE PUPIL
  • 6. IN SEPTEMBER 2008 PATEINT WAS 25 YEARS OLD • 24 HRS HISTORY • FEVER • VOMITING • NECK RIGIDITY
  • 7. CSF ANALYSIS IN BOTH CASES • ELEVATED PROTEIN LEVEL • ELEVATED NEUTROPHILIC PLEOCYTOSIS • HYPOGLYCORRHACHIA • GS AND LA WERE NEGATIVE
  • 8. TILL APRIL2009 NO PAM DETECTED IN APRIL 2009 THERE WERE 11 PATIENTS WITH PAM REFERRED TO AKU
  • 9. THOSE PATEINTS WERE TREATED WITH AMPHOTERECIN B RIFAMPIN,FLUCONAZOLNZOOLRIFA MOITHEY WERE INCUBATED AND VANTILATED AFTRE HOSPITAL ADMISSION BUT NO ONE SURVIVED
  • 10. 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
  • 11. ON THE BASIS OF THESE DIAGNOSIS WET MOUNT DONE BY LAB
  • 12. MOLECULAR DIAGNOSIS: IN JUNE 2009 CSF COLLECTED FROM 3 PATIENTS AND CONFIRMED THE INFECTION BY REAL TIME PCR
  • 13. 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
  • 14. 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
  • 15. • THIS WAS DETECTED BY HEXACHLOROFLUORESCEIN(HEX) LABELED PROBE Nfowl(5’-HEX-AT AGC AAT ATA TTC AGG GGA GCT GGG C- BHQ1-3’)
  • 16. PCR PERFORMANCE 2 INITIAL INCUBATIONS AT 50 C WITH URACIL-DNA- GLYCOSYLASE ACTIVITY FOR 2 MINS
  • 17. 2ND AT 95 C WITH ACTIVATION OF PLATINIUM Taq DNA POLYMERASE) FLOURESECNCE WAS MEASURED
  • 18. 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

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