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Excerpt from a recent article in the journal Parasitological Acta:
Confirmation by real-time PCR of a fatal case of primary amoebic meningoencephalitis in Turkey caused by Naegleria fowleri or brain-eating amoeba
Naegleria fowleri, the causative agent of primary amoebic meningoencephalitis (PAD), is a free-living amoeba. It is a waterborne infection usually detected in children and young people with healthy immune systems who swim, dive and perform activities in cool and hot springs.
In this study, the aim was to raise awareness of the differential diagnosis of the etiopathogenesis of meningitis by showing that N. fowleri can also be the causative agent, although very rarely, of cases of meningitis in Turkey.
Our case was an 18-year-old male patient whose relatives said he had been to the hot spring; his headache complaint started 2-3 days after returning from the hot spring. A sample of cerebrospinal fluid (CSF) taken from the patient was studied by direct microscopic examination, real-time PCR method and sequence analysis.
The collected CSF sample was placed in distilled water considering the possibility of transformation of trophozoites into intermediate form and incubated at 37°C for 1-2h, and pear-shaped non-permanent flagellated forms were were observed on direct microscopic examination, and molecular typing was performed to confirm the diagnosis. This study was a complete case of N. fowleri whose etiological agent was isolated and confirmed by real-time PCR in Turkey.
Clinician awareness would be the key factor to correctly diagnose PAM. It is also recommended to investigate all probable environmental water sources in Turkey to obtain more detailed information on the distribution and molecular identification of Naegleria species, ultimately to assess the potential pathogenic threat to human health and to develop strategies to combat these threats.
Oncel K, Karaagac L, Dagcı H, Aykur M. Confirmation by real-time PCR of a fatal case of primary amoebic meningoencephalitis in Turkey caused by Naegleria fowleri or brain-eating amoeba. Acta Parasitol. 2022 Jan 12. doi: 10.1007/s11686-021-00514-0. Epub ahead of print. PMID: 35020127.