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Case Series of Naegleria fowleri Primary Ameobic Meningoencephalitis from Karachi, Pakistan

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  • 1 Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi, Pakistan;
  • | 2 Department of Medicine, Aga Khan University, Karachi, Pakistan

Naegleria fowleri causes primary amoebic meningoencephalitis (PAM) which is almost always fatal. Naegleria fowleri is waterborne, and its infections are usually associated with aquatic activities but it can also be transmitted via the domestic water supply. An increasing number of N. fowleri cases have been reported from Pakistan. Improved methods for diagnosis are required. We report the utility of polymerase chain reaction (PCR) for the diagnosis of N. fowleri in patients suspected of PAM. One hundred and sixteen cases suspected of having PAM were examined. Cerebrospinal fluid (CSF) specimens were tested at the Aga Khan University Hospital, Karachi. Nineteen CSF specimens were positive for N. fowleri using PCR. Naegleria fowleri positive patients had a median age of 28 years and were 84% male and 16% female. Overall, CSF wet preparation microscopy was performed in 85 (73%) cases and identified that seven specimens were positive for motile trophozoites. The CSF wet preparation results were available for 15 of the 19 N. fowleri PCR positive CSF samples; seven (40%) wet preparations were positive. Our data highlight the threat of N. fowleri infection as a cause of PAM. It also emphasizes the utility of the PCR-based diagnosis of the amoeba for early diagnosis and management of the disease.

Author Notes

Address correspondence to Zahra Hasan, Department of Pathology and Laboratory Medicine, Aga Khan University, Stadium Road, P.O. Box 3500, Karachi 74800, Pakistan. E-mail: zahra.hasan@aku.edu

Authors’ addresses: Najia K. Ghanchi, Erum Khan, Zeeshan Ansar, Azra Samreen, Afia Zafar, and Zahra Hasan, Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi, Pakistan, E-mails: najia.ghanchi@aku.edu, erum.khan@aku.edu, zeeshan.ansar@aku.edu, azra.samreen@aku.edu, afia.zafar@aku.edu, and zahra.hasan@aku.edu. Bushra Jamil, Department of Medicine, Aga Khan University, Karachi, Pakistan, E-mail: bushra.jamil@aku.edu.

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