Amebic meningoencephalitides and keratitis: challenges in diagnosis and treatment*
Summary of "Amebic meningoencephalitides and keratitis: challenges in diagnosis and treatment*"
Acanthamoeba spp., Balamuthia mandrillaris, and Naegleria fowleri, although free-living amebae, also cause devastating diseases in humans leading to death. Acanthamoeba spp. and B. mandrillaris cause granulomatous amebic encephalitis, cutaneous and nasopharyngeal as well as disseminated infection. Acanthamoeba also causes a vision-threatening infection of the cornea, Acanthamoeba keratitis, principally in contact lens wearers. N. fowleri causes an acute, fulminating infection of the central nervous system, primary amebic meningoencephalitis, in healthy children and young adults who indulge in aquatic activities in fresh water. This review focuses on the recent developments in the diagnosis and treatment and clinical management of the diseases caused by these amebae. RECENT
Development of a multiplex real-time PCR test has made it possible to simultaneously detect all the three free-living amebae in a sample. It is a rapid assay with a short turn-around time of just 4-5 h. An early diagnosis would be helpful in initiating potentially effective treatment. A recent study reported exciting results indicating that loading of rokitamycin in chitosan microspheres improves and prolongs the in-vitro anti-Acanthamoeba activity of the drug.
Diagnoses of these infections are challenging and antimicrobial therapy is empirical, which often results in fatalities. Further research is needed to explore the possibility of a better drug delivery system that crosses the blood-brain barrier and effectively reach the central nervous system.
Centers for Disease Control and Prevention, Atlanta, Georgia, USA *This article is dedicated to the memory of Dr Frederick L. Schuster, a good friend and an often collaborator.
This article was published in the following journal.
Name: Current opinion in infectious diseases
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/20802332
- DOI: http://dx.doi.org/10.1097/QCO.0b013e32833ed78b
Medical and Biotech [MESH] Definitions
DYSENTERY caused by intestinal amebic infection, chiefly with ENTAMOEBA HISTOLYTICA. This condition may be associated with amebic infection of the LIVER and other distant sites.
Infection with amoebae of the genus ENTAMOEBA. Infection with E. histolytica causes DYSENTERY, AMEBIC and LIVER ABSCESS, AMEBIC.
A species of parasitic protozoa causing ENTAMOEBIASIS and amebic dysentery (DYSENTERY, AMEBIC). Characteristics include a single nucleus containing a small central karyosome and peripheral chromatin that is finely and regularly beaded.
A superficial, epithelial Herpesvirus hominis infection of the cornea, characterized by the presence of small vesicles which may break down and coalesce to form dendritic ulcers (KERATITIS, DENDRITIC). (Dictionary of Visual Science, 3d ed)
A form of herpetic keratitis characterized by the formation of small vesicles which break down and coalesce to form recurring dendritic ulcers, characteristically irregular, linear, branching, and ending in knoblike extremities. (Dictionary of Visual Science, 3d ed)
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