Naqi Rohana, Azeemuddin Muhammad
Department of Radiology, Dow University of Health Sciences, 2Department of Radiology, Aga Khan University Hospital, Karachi.
J Pak Med Assoc. 2013 Mar;63(3):399-402.
The imaging findings in four cases of a rare infection of the central nervous system caused by amoebae, Naeglaeria fowleri are presented. Naeglaeria fowleri are pathogenic free-living amoebae. They cause primary amoebic meningoencephalitis (PAM), a rapidly fatal disease of the central nervous system. The computed tomography brain findings in 3 (75%) of our cases of pan amoebic meningoencephalitis showed non-specific brain oedema; 2 (66%) of these cases also had moderate hydrocephalus and among that 1 (50%) case showed an old lacunar infarction in peri-ventricular region. In the remaining 1 (25%) case the scan was normal with no evidence of oedema or abnormal lesion. Out of three cases with diffuse brain oedema, postcontrast images showed abnormal meningeal enhancement throughout the brain parenchyma in 1 (33%) case. However, no definite focal enhancing lesion was noted. In the rest of the cases, no abnormal parenchymal or meningeal enhancement was seen on post-contrast images.
本文报告了4例由福氏耐格里阿米巴引起的罕见中枢神经系统感染病例的影像学表现。福氏耐格里阿米巴是致病性自由生活阿米巴。它们可引起原发性阿米巴脑膜脑炎（PAM），这是一种中枢神经系统的快速致死性疾病。在我们的3例（75%）泛发性阿米巴脑膜脑炎病例中，脑部计算机断层扫描结果显示为非特异性脑水肿；其中2例（66%）还伴有中度脑积水，其中1例（50%）在脑室周围区域有陈旧性腔隙性梗死。其余1例（25%）扫描结果正常，无水肿或异常病变迹象。在3例弥漫性脑水肿病例中，增强扫描图像显示1例（33%）整个脑实质有异常脑膜强化。然而，未发现明确的局灶性强化病变。在其余病例中，增强扫描图像上未见到实质或脑膜异常强化。
