Nueva publicación de la Dra Dalila Martínez y el Dr Alfonso Cabello en el Acta Parasitologica.

Successful Treatment of Primary Amoebic Meningoencephalitis Using a Novel Therapeutic Regimen Including Miltefosine and Voriconazole

Dalila Y Martínez 1 2, Fanny Bravo-Cossio 3, María Del Carmen Valdivia-Tapia 3, Nilton Yhuri Carreazo 4, Alfonso M Cabello-Vilchez 1 5

Affiliations

  1. Instituto de Medicina Tropical "Alexander Von Humboldt", Universidad Peruana Cayetano Heredia, Lima, Perú.
  2. Departamento de Enfermedades Infecciosas, Tropicales y Dermatológicas, Hospital Cayetano Heredia, Lima, Perú.
  3. Hospital de Emergencias Pediátricas, Lima, Perú.
  4. Hospital de Emergencias Pediátricas, Lima, Perú. Esta dirección de correo electrónico está siendo protegida contra los robots de spam. Necesita tener JavaScript habilitado para poder verlo..
  5. Universidad Privada Norbert Wiener, Escuela de Tecnología Médica en Laboratorio Clínico y Anatomía Patológica, Lima, Perú.

DOI: 10.1007/s11686-022-00591-9

Abstract

The genus Naegleria consists of free-living amoebae widely distributed worldwide in soil and freshwater habitats. Primary amoebic meningoencephalitis (PAM) is an uncommon and most likely fatal disease. The incubation period is approximately 7 days. The first symptoms are headache, nasal congestion, fever, vomiting, stiff neck within 3-4 days after the first symptoms, confusion, abnormal behavior, seizures, loss of balance and body control, coma, and death. We describe the case of a child who presented with PAM due to Naegleria sp., fully recovered from the infection without apparent sequels after treatment with a regimen that included miltefosine and voriconazole.

Keywords: Central nervous system protozoal infections; Child; Miltefosine; Naegleria; Voriconazole.

© 2022. The Author(s) under exclusive licence to Witold Stefański Institute of Parasitology, Polish Academy of Sciences.

 

Fig 1. A Initial brain computed tomography (CT) scan, obtained at the admittance, showed difuse edema. B Gadolinium- enhanced magnetic resonance image (MRI) got 2 weeks after treatment, showing the disap-pearance of brain edema, and reported as normal. C Tropho-zoites suggestive of Naegleria sp. in methylene blue stain of cerebrospinal fuid (CSF). D, E, and F Sequence of trophozoites in motion in a wet mount of CSF, suggestive of Naegleria sp. Red arrows point to short pseudopods of trophozoites in movement

 

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