Mesh : Amebiasis / mortality nursing transmission Brain Death Central Nervous System Protozoal Infections / mortality nursing transmission Cooperative Behavior Diagnosis, Differential Fatal Outcome Humans Interdisciplinary Communication Male Naegleria fowleri Neurologic Examination Nurse Clinicians Patient Care Team Risk Factors Tissue and Organ Procurement Young Adult

来  源:   DOI:10.1097/JNN.0b013e318227ef6e   PDF(Sci-hub)

Abstract:
Primary amoebic meningoencephalitis (PAM) is a rare and rapidly fatal disease caused by the Naegleria fowleri amoeba. It is a diagnosis rarely seen by medical personnel, yet this amoeba is frequently encountered by people who frequent freshwater bodies of water in certain states. The disease primarily affects children and young adults who swim or take part in water sports in the waters in which the amoeba thrive. The disease presents with symptomatology similar to bacterial meningitis: headache, stiff neck, altered mental status, seizures, and coma with a quick progression to death. Rapid diagnosis is imperative to facilitate prompt treatment, although PAM has 95% mortality. There have been only 10 survivors reported in medical literature. This disease is a public-health risk to those living in affected areas of the country. Healthcare providers need to be cognizant of the disease as well, and, although recovery is rare, focus on prevention and risk reduction strategies is imperative. It is not completely understood why, of the millions of people are exposed to freshwater with the amoeba, only a few become infected with it. The Centers for Disease Control and Prevention have suggested that all freshwater areas should always assume a level of risk in waters, even when signage is not posted. This case study will review a fatal case of Naegleria fowleri infection in a young patient and will include the pathophysiology, diagnosis, treatment, nursing and public health implications, and organ procurement that occurred with the patient.
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