Król-Turmińska Katarzyna, Olender Alina
Chair and Department of Medical Microbiology, Medical University of Lublin, Poland.
Ann Agric Environ Med. 2017 May 11;24(2):254-260. doi: 10.5604/12321966.1233568.
[b]Abstract Introduction[/b]. Among free-living amoebae that are widely distributed in nature only four genera/species are known as agents of human infections:[i] Acanthamoeba spp., Naegleriafowleri, Balamuthia mandrillaris[/i] and[i] Sappiniapedata[/i]. These amoebae are not well adapted to parasitism, and could exist in the human environment without the need for a host. Infections due to these amoebae, despite low morbidity, are characterized by relatively high mortality rate and pose serious clinical problems. [b]Objectve[/b]. This review study presents and summarizes current knowledge about infections due to pathogenic and opportunistic free-living amoebae focused on epidemiology, clinical manifestations, diagnosis and treatment based on global literature. [b]State of knowledge[/b]. All four genera have been recognized as etiologic factors of fatal central nervous system infections and other serious diseases in humans. [i]N. fowleri[/i] causes an acute fulminating meningoencephalitis in children and young adults. [i]Acanthamoeba spp[/i]. and [i]B.mandrillaris[/i] are opportunistic pathogens causing granulomatous amoebic encephalitis and disseminated or localized infections which could affect the skin, sinuses, lungs, adrenals and/or bones. [i]Acanthamoeba spp[/i]. is also the main agent of acute eye infection -[i] Acanthamoeba keratitis, [/i]mostly in contact lens wearers. However, there is only one recognized case of encephalitis caused by [i]S. pedata. [/i] [b]Conclusions[/b]. Amoebic diseases are difficult to diagnose which leads to delayed treatment, and result in a high mortality rate. Considering those issues, there is an urgent need to draw more attention to this type of diseases.
摘要 引言。在自然界广泛分布的自由生活阿米巴中，只有四个属/种被认为是人类感染的病原体：棘阿米巴属、福氏耐格里阿米巴、曼氏巴贝斯虫和佩氏萨平内阿米巴。这些阿米巴对寄生生活适应性不强，无需宿主就能在人类环境中生存。这些阿米巴引起的感染，尽管发病率较低，但死亡率相对较高，会引发严重的临床问题。目的。本综述性研究基于全球文献，介绍并总结了关于致病性和机会性自由生活阿米巴感染的现有知识，重点关注流行病学、临床表现、诊断和治疗。知识现状。所有这四个属都已被确认为人类致命性中枢神经系统感染和其他严重疾病的病因。福氏耐格里阿米巴在儿童和年轻人中引起急性暴发性脑膜脑炎。棘阿米巴属和曼氏巴贝斯虫是机会性病原体，可引起肉芽肿性阿米巴脑炎以及可影响皮肤、鼻窦、肺、肾上腺和/或骨骼的播散性或局限性感染。棘阿米巴属也是急性眼部感染——棘阿米巴角膜炎的主要病原体，主要发生在佩戴隐形眼镜的人群中。然而，仅有一例佩氏萨平内阿米巴引起脑炎的确诊病例。结论。阿米巴病难以诊断，导致治疗延误，死亡率很高。鉴于这些问题，迫切需要更多地关注这类疾病。
