Mary D. Nettleman, MD, MS, MACP is the Chair of the Department of Medicine at Michigan State University. She is a graduate of Vanderbilt Medical School, and completed her residency in Internal Medicine and a fellowship in Infectious Diseases at Indiana University.
Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
What are symptoms and signs of a Naegleria fowleri infection?
After entering
the nose, the amoeba travels into the brain along the olfactory nerve and
through membranes to enter the brain. Once there, it causes primary amoebic meningoencephalitis (meaning inflammation of the brain and the lining around the
brain). In the popular press, Naegleria fowleri is sometimes called the brain-eating amoeba, and meningoencephalitis is sometimes
referred to as Naegleriasis.
Symptoms usually appear within five days after exposure but can be delayed
up to two weeks. Patients may initially notice changes in smell or taste.
Fever,
headache, loss of appetite, and nausea follow quickly. The patient becomes
confused or semiconscious and finally comatose. Physical examination shows
fever and a stiff neck (meningismus).
How is a Naegleria fowleri infection diagnosed?
A spinal tap will be done to
examine the spinal fluid. Infection is diagnosed by seeing the amoeba under the
microscope. Traditional Gram staining is not used to detect Naegleria because
the heat used in the fixation process destroys the organism. Although not specific
to Naegleria, the spinal fluid often has a mild elevation in the levels of
proteins and a mild decrease in glucose, along with a high white cell count, and
is often bloody in the later stages of disease.
Because rapid diagnosis is critical, examination of the spinal fluid is
imperative. The organism can also be cultured in the laboratory using on a plate
that is coated with bacteria for the amoeba to eat. The culture takes a few days.
Newer tests are becoming available that use polymerase chain reaction (PCR)
technology to detect amoebic DNA in spinal fluid.
Headaches can be divided into two categories: primary headaches and secondary headaches. Migraine headaches, tension headaches, and cluster headaches are considered primary headaches. Secondary headaches are caused by disease. Headache symptoms vary with the headache type. Over-the-counter pain relievers provide short-term relief for most headaches.
Nausea is an uneasiness of the stomach that often precedes vomiting. Nausea and vomiting are not diseases, but they are symptoms of many conditions. The causes of vomiting differ according to age, and treatment depends upon the cause of nausea and vomiting.
Although a fever technically is any body temperature above the normal of 98.6 degrees F. (37 degrees C.), in practice a person is usually not considered to have a significant fever until the temperature is above 100.4 degrees F (38 degrees C.). Fever is part of the body's own disease-fighting arsenal: rising body temperatures apparently are capable of killing off many disease- producing organisms.
Epilepsy is a brain disorder in which the person has seizures. There are two kinds of seizures, focal and generalized. There are many causes of epilepsy. Treatment of epilepsy (seizures) depends upon the cause and type of seizures experienced.
Encephalitis is a brain inflammation that causes sudden fever, vomiting, headache, light sensitivity, stiff neck and back, drowsiness, and irritability. Meningitis is an infection that causes inflammation of the meninges that surround the brain and spinal cord. Symptoms of meningitis include high fever, headache, nausea, vomiting, and stiff neck.
Recreational Water Illnesses (RWIs) are caused by germs spread by breathing in mists or aerosols, swimming, or having contact with contaminated water in hot tubs, water parks, water play areas, fountains, lakes, rivers, oceans, and swimming pools. Diarrhea is the most commonly reported recreational water illness. Diarrheal illnesses are caused by germs such as Crypto, Shigella, Norovirus, E. coli, and Giardia. Prevention of water born illnesses is key to avoid infection. Avoid swallowing water and practice good hygiene habits are a must.
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