OSPE PAM

Question 1

CASE

Answer 1

headaches, vomiting and fever of 24 hr duration. disturbance of consciousness for 22 h prior to admission. unconscious, had seizures and required treatment with a tracheal intubation ventilator.
patient went swimming three days prior

Question 2

microscopy

Answer 2

wet mount of the CSF
Naegleria fowleri,blunt pseudopodia

Question 3

CSF findings

Answer 3

• Low glucose, high protein
• Leucocytosis
• Increase in neutrophils/ polymorphonuclear cells and monocytes
• Presence of RBCs

Question 4

State the THREE stages of this organism

Answer 4

Trophozoite stage, flagellated stage & cyst stage

Question 5

State the mode by which they gain entry into the human body

Answer 5

They enter through the nasal cavity while in contact with water which contain these free-living amoebae

Question 6

What is the risk factor in acquiring this infection in this case ?

Answer 6

Swimming in water

Question 7

clinical manifestations of PAM

Answer 7

similar to those of bacterial meningitis, including severe headaches, high fever, projectile vomiting, seizures, neck stiffness, changes in the level of consciousness and meningeal irritation. Within 1 –12 days after the onset of initial symptoms, the condition progresses rapidly, and patients often die from increased intracranial pressure and brain herniation