Nicolas M, De Jonckheere J F, Pernin P, Bataille H, Le Bris V, Herrmann-Storck C
Service de microbiologie, CHU de Pointe-à-Pitre, BP 465, F-97159, Pointe-à-Pitre, Guadeloupe, France.
Bull Soc Pathol Exot. 2010 Feb;103(1):14-8. doi: 10.1007/s13149-009-0028-1. Epub 2010 Jan 22.
We report the first case of primary amoebic meningoencephalitis in a 9-year-old boy in Guadeloupe. The outcome was rapidly fatal in 7 days. The patient presumably acquired the infection by swimming and diving in a basin supplied by natural thermal water 1 week before onset of the disease. The possibility of a free-living amoeba infection was suspected both on the negativity of all bacterial and viral initial tests and on the observation of peculiar cells in stained cerebrospinal fluid samples. Although the amoeba was not isolated, Naegleria fowleri could be identified by polymerase chain reaction with specific primers on DNA extracted from frozen cerebrospinal fluid samples. Furthermore, as the internal transcribed spacer (ITS1) region of DNA is variable in length between the different strains of N. fowleri, sequencing of the amplified ITS1 demonstrated that the responsible N. fowleri strain belongs to a common genotype present in the American and European continent.
我们报告了瓜德罗普岛一名9岁男孩原发性阿米巴脑膜脑炎的首例病例。7天内病情迅速恶化至致命。患者可能在发病前1周在天然温泉供水的水池中游泳和潜水时感染。由于所有细菌和病毒初始检测均为阴性，以及在染色脑脊液样本中观察到特殊细胞，怀疑存在自由生活阿米巴感染。尽管未分离出阿米巴，但通过对从冷冻脑脊液样本中提取的DNA使用特异性引物进行聚合酶链反应，可以鉴定出福氏耐格里阿米巴。此外，由于福氏耐格里阿米巴不同菌株之间DNA的内转录间隔区（ITS1）长度可变，对扩增的ITS1进行测序表明，致病的福氏耐格里阿米巴菌株属于在美洲和欧洲大陆存在的常见基因型。
