Thong Y H
Med J Aust. 1980 Apr 19;1(8):352-4. doi: 10.5694/j.1326-5377.1980.tb134919.x.
Primary amoebic meningoencephalitis is a fulminant and rapidly fatal diseases which principally affects children and young adults. The causative organism is Naegleria fowleri, an amoebo-flagellate found in most soil and freshwater habitats. The portal of entry is the nasopharynx from which the amoeba makes its way into the brain by penetration of the olfactory mucosa and cribriform plate. Diagnosis should be suspected in all cases of purulent meningitis and meningoencephalitis in which bacteria are not evident in the cerebrospinal fluid. Diagnosis can be made by microscopic examination of a fresh specimen of cerebrospinal fluid, or a specimen strained with Wright's or Gram's stain. Combination chemotherapy with amphotericin B and tetracycline, or amphotericin B and rifamycin, by intravenous, intrathecal, and when possible, intraventricular instillation, may offer some hope of success. Preventive measures include constant surveillance of domestic water supplies and swimming pools for amoebic contamination, and education of the public to avoid swimming in contaminated areas.
原发性阿米巴脑膜脑炎是一种暴发性且迅速致命的疾病，主要影响儿童和年轻人。致病生物是福氏耐格里阿米巴，一种在大多数土壤和淡水生境中发现的变形鞭毛虫。感染途径是鼻咽部，阿米巴通过穿透嗅黏膜和筛板进入大脑。在所有脑脊液中未发现细菌的化脓性脑膜炎和脑膜脑炎病例中均应怀疑诊断。可通过对新鲜脑脊液标本或经瑞氏或革兰氏染色的标本进行显微镜检查来确诊。通过静脉内、鞘内注射，以及在可能的情况下进行脑室内滴注，联合使用两性霉素B和四环素，或两性霉素B和利福霉素进行化疗，可能带来一些成功的希望。预防措施包括持续监测家庭供水和游泳池是否受到阿米巴污染，以及教育公众避免在受污染地区游泳。
