RESUMO
Primary amebic meningoencephalitis (PAM) is a rare and lethal infection caused by Naegleria fowleri. We report an epidemiological and environmental investigation relating to a case of PAM in a previously healthy boy age 8 years. An interview of the patient's family was conducted to determine the likely exposure site and to assess risk factors. Data from the United States Geological Survey site at Waterloo, NE, on the Elkhorn River were used to estimate water temperature and streamflow at the time and site of exposure. Data from the National Weather Service were used to estimate precipitation and ambient air temperature at the time and site of exposure. Despite conventional treatment, the patient died 2 days after hospital admission. The patient participated in recreational water activities in the Elkhorn River in northeastern Nebraska 5 days before symptom onset. In the week before exposure, water and ambient air high temperatures reached annual highs, averaging 32.4°C and 35.8°C, respectively. The day before infection, 2.2 cm of precipitation was reported. Streamflow was low (407 ft3/s). Infections in several northern states, including Nebraska, suggest an expanding geographic range of N. fowleri transmission, which may lead to increased incidence of PAM in the United States. Similar environmental investigations at suspected exposure sites of future cases will allow data aggregation, enabling investigators to correlate environmental factors with infection risk accurately.
Assuntos
Amebíase , Infecções Protozoárias do Sistema Nervoso Central , Meningoencefalite , Naegleria fowleri , Masculino , Humanos , Estados Unidos/epidemiologia , Criança , Nebraska , Infecções Protozoárias do Sistema Nervoso Central/diagnóstico , Infecções Protozoárias do Sistema Nervoso Central/epidemiologia , Água , Rios , Meningoencefalite/epidemiologia , Meningoencefalite/diagnóstico , Amebíase/epidemiologia , Amebíase/diagnósticoRESUMO
We compared two commercial PCR assays, the Prodesse ProGastro CD assay and the BD GeneOhm Cdiff assay, with a laboratory-developed Clostridium difficile toxin PCR assay with previously established performance characteristics. Results of all methods were in agreement for 333 (96%) of 346 stool specimens. No significant difference in performance among the assays was found (P values, >0.05).
Assuntos
Técnicas Bacteriológicas/métodos , Clostridioides difficile/isolamento & purificação , Infecções por Clostridium/diagnóstico , Técnicas de Diagnóstico Molecular/métodos , Toxinas Bacterianas/genética , Clostridioides difficile/genética , Infecções por Clostridium/microbiologia , Fezes/microbiologia , Humanos , Kit de Reagentes para Diagnóstico , Sensibilidade e EspecificidadeAssuntos
Antígenos de Bactérias/análise , Bactérias/citologia , Técnicas Bacteriológicas/métodos , Líquido Cefalorraquidiano/química , Líquido Cefalorraquidiano/microbiologia , Meningites Bacterianas/diagnóstico , Humanos , Imunoensaio/métodos , Microscopia/métodos , Estudos Retrospectivos , Sensibilidade e Especificidade , Coloração e Rotulagem/métodosAssuntos
Imunoensaio/métodos , Vírus da Influenza A Subtipo H1N1/isolamento & purificação , Influenza Humana/diagnóstico , Influenza Humana/virologia , Técnicas de Diagnóstico Molecular/métodos , Reação em Cadeia da Polimerase/métodos , Centers for Disease Control and Prevention, U.S. , Humanos , Vírus da Influenza A Subtipo H1N1/genética , Sensibilidade e Especificidade , Estados UnidosRESUMO
Acute gestational hepatitis from herpes simplex virus (HSV) infection is a rare but potentially life-threatening condition. We present the first reported case of primary HSV type 2 hepatitis in a pregnant woman who was diagnosed by detection of HSV-2 viremia via real-time polymerase chain reaction. The patient was successfully treated with acyclovir and delivered a healthy infant.