reference : Fatal Naegleria fowleri infection acquired in Minnesota: Possible expanded range of a deadly thermophilic organism

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reftype Journal Article
Abstract BACKGROUND: Primary amebic meningoencephalitis (PAM), caused by the free-living ameba Naegleria fowleri, has historically been associated with warm freshwater exposures at lower latitudes of the United States. In August 2010, a Minnesota resident, aged 7 years, died of rapidly progressive meningoencephalitis after local freshwater exposures, with no history of travel outside the state. PAM was suspected on the basis of amebae observed in cerebrospinal fluid. METHODS: Water and sediment samples were collected at locations where the patient swam during the 2 weeks preceding illness onset. Patient and environmental samples were tested for N. fowleri with use of culture and real-time polymerase chain reaction (PCR); isolates were genotyped. Historic local ambient temperature data were obtained. RESULTS: N. fowleri isolated from a specimen of the patient's brain and from water and sediment samples was confirmed using PCR as N. fowleri genotype 3. Surface water temperatures at the times of collection of the positive environmental samples ranged from 22.1 degrees C to 24.5 degrees C. August 2010 average air temperature near the exposure site was 25 degrees C, 3.6 degrees C above normal and the third warmest for August in the Minneapolis area since 1891. CONCLUSIONS: This first reported case of PAM acquired in Minnesota occurred 550 miles north of the previously reported northernmost case in the Americas. Clinicians should be aware that N. fowleri-associated PAM can occur in areas at much higher latitude than previously described. Local weather patterns and long-term climate change could impact the frequency of PAM.
Author Kemble, S. K.; Lynfield, R.; DeVries, A. S.; Drehner, D. M.; Pomputius, W. F.; Beach, M. J.; Visvesvara, G. S.; da Silva, A. J.; Hill, V. R.; Yoder, J. S.; Xiao, L.; Smith, K. E.; Danila, R.
DOI 10.1093/cid/cir961
Date Mar
ISSN 1537-6591
Issue 6
Journal Clinical Infectious Diseases
Keywords Amebiasis/cerebrospinal fluid/ parasitology; Animals; Brain/parasitology; Central Nervous System Protozoal Infections/cerebrospinal fluid/ parasitology; Child; Fatal Outcome; Female; Humans; Lakes/ parasitology; Minnesota; Naegleria fowleri/ isolation & purification; Swimming; Water Microbiology
Language eng
Notes Kemble, Sarah K Lynfield, Ruth DeVries, Aaron S Drehner, Dennis M Pomputius, William F 3rd Beach, Michael J Visvesvara, Govinda S da Silva, Alexandre J Hill, Vincent R Yoder, Jonathan S Xiao, Lihua Smith, Kirk E Danila, Richard 3U01CI000313/CI/NCPDCID CDC HHS/United States Case Reports Research Support, U.S. Gov't, P.H.S. United States Clin Infect Dis. 2012 Mar;54(6):805-9. doi: 10.1093/cid/cir961. Epub 2012 Jan 11.
Pages 805-809
Title Fatal Naegleria fowleri infection acquired in Minnesota: Possible expanded range of a deadly thermophilic organism
Volume 54
Year 2012
Bibliographic identifiers
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_record_number 4638
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