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Patients with ICD-10-CM codes for Naegleriasis in U.S. hospitals, 2016-2024: A retrospective analysis of
Thad Wilkins1, Alyssa Harris2, Will Cagle3
1Department of Family and Community Medicine, Medical College of Georgia at Augusta University, Augusta, Georgia, USA.
Objectives:
Naegleria fowleri is a free-living amoeba that causes primary amoebic meningoencephalitis (PAM), a rare and nearly always fatal infection. Other free-living amoebae may cause similar presentations. This study characterizes demographic features, clinical outcomes, and antimicrobial use among patients coded with naegleriasis in a large administrative database.
Methods:
A retrospective analysis was conducted using the Vizient® Clinical Database, which includes discharge-level data from over 500 U.S. hospitals. Patients discharged between January 2016 and February 2024 with ICD-10-CM code B60.2 (naegleriasis) were identified. Demographics, inpatient mortality, antimicrobial use, and discharge disposition were summarized using descriptive statistics.
Results:
Twenty-two patients were identified. The mean age was 37 years; 73% were adults. In-hospital mortality was 50%. Survivors had longer hospital stays than nonsurvivors. Amphotericin B and fluconazole were the most used antimicrobials. Diagnostic confirmation of PAM was unavailable, and additional clinical details were not accessible.
Conclusions:
Patients coded with naegleriasis were mostly adults and had lower mortality than expected for confirmed PAM. The 50% survival rate suggests possible misclassification. These findings are hypothesis-generating and highlight the need for case-based studies with laboratory confirmation to clarify epidemiologic trends.
Insights
Naegleria fowleri infections, coded as naegleriasis, primarily affect adults. A 50% survival rate suggests potential misdiagnosis, warranting further investigation with laboratory confirmation.
Area of Science:
- Infectious Diseases
- Clinical Epidemiology
- Public Health
Background:
- Naegleria fowleri causes primary amoebic meningoencephalitis (PAM), a rare and often fatal brain infection.
- Other free-living amoebae can present with similar clinical symptoms.
- Accurate diagnosis and understanding of naegleriasis epidemiology are crucial.
Purpose of the Study:
- To characterize demographic features of patients coded with naegleriasis.
- To analyze clinical outcomes, including mortality and antimicrobial use.
- To investigate potential misclassification in administrative data.
Main Methods:
- Retrospective analysis of a large U.S. administrative database (Vizient® Clinical Database).
- Inclusion of patients with ICD-10-CM code B60.2 (naegleriasis) discharged between January 2016 and February 2024.
- Descriptive statistics for demographics, mortality, antimicrobial use, and discharge disposition.
Main Results:
- Twenty-two patients coded with naegleriasis were identified.
- The average age was 37 years, with 73% being adults.
- In-hospital mortality was 50%, with survivors experiencing longer hospital stays. Amphotericin B and fluconazole were common treatments.
Conclusions:
- Patients coded as having naegleriasis were predominantly adults with a lower mortality rate than expected for confirmed PAM.
- The observed 50% survival rate suggests a possibility of misclassification in the coding.
- Further case-based studies with laboratory confirmation are needed to clarify epidemiologic trends of naegleriasis.
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