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A case of primary amebic meningoencephalitis in Zaria, Nigeria
Abstract:
A case of primary amebic meningoencephalitis due to Naegleria fowleri in a Nigerian child is described. This is probably the first authentic case from West Africa. The clinical manifestations, isolation of the ameba from the cerebrospinal fluid and nasal passages, poor response to amphotericin B, and ultimate fatal outcome all are consistent with the diagnosis of primary amebic meningoencephalitis. Subsequent identification based on morphologic features, flagellation, animal pathogenicity, and nuclear division proved conclusively that the ameba was Naegleria fowleri. The route of entry of the ameba proved to be nasal. In the absence of the history of swimming and in view of the dusty harmattan period during which the child was admitted, a possibility of infection by inhalation of dust harboring amebic cysts is suggested.
Insights
This report details a fatal case of primary amebic meningoencephalitis caused by Naegleria fowleri in a Nigerian child, likely the first in West Africa. Infection may occur via dust inhalation, not just swimming.
Area of Science:
- Neurology
- Infectious Diseases
- Parasitology
Background:
- Primary amebic meningoencephalitis (PAM) is a rare and severe infection of the central nervous system.
- Naegleria fowleri is a free-living ameba known to cause PAM, typically through nasal inoculation during water-related activities.
Observation:
- A case of PAM in a Nigerian child is presented, likely the first documented in West Africa.
- Clinical symptoms, isolation of Naegleria fowleri from cerebrospinal fluid and nasal passages, and a fatal outcome were observed.
- The ameba was definitively identified as Naegleria fowleri through morphological and pathogenic characteristics.
Findings:
- The route of infection was determined to be nasal.
- Treatment with amphotericin B showed a poor response.
- A potential transmission route through inhalation of dust containing amebic cysts during the harmattan season is proposed, distinct from typical waterborne infections.
Implications:
- This case highlights the potential for Naegleria fowleri infection in West Africa.
- It suggests alternative transmission routes, such as dust inhalation, should be considered in endemic areas.
- Further research into environmental reservoirs and transmission dynamics of Naegleria fowleri in diverse climates is warranted.