Brain drain: Lethal amoebae take devastating toll

Reincarnation doesn’t sound appealing to me. For example, it seems all the Hollywood stars were kings or some other fantastic legends in past lives. Why couldn’t they have just been ho-hum people? However, if reincarnation does exist, in my past lives, I'd like to have been Cary Grant, and before that Abe Lincoln, and before that, Cleopatra! Is that asking too much?

Can you imagine coming back as an amoeba?

Do you remember looking at amoebae in life science classes? Under the microscope, amoebae look like blots of Slime! (that oochie-goochie green mess in a can that kids play with). Amoebae are protozoan parasites, but unlike other parasites, these don’t need a host to survive and replicate.

N. fowleri is known as the “brain-eating amoebic.” It was first described in Australia in 1965 and has since been diagnosed in a few people in FL, TX, CA, AK, and AZ. I read it was even a diagnosis made on season two of House, M.D. (I never watch medical shows because their medical information is as accurate as advice from television financial experts.)

N. fowleri lives in warm fresh water such as thermally polluted streams and rivers, man-made lakes and ponds, and hot springs. It enters our bodies via the nose. I never jump into fresh water without plugging my nose, because one theory is the pressure of water up the nose can let N. fowleri jet up to the brain.

In the Oscar-nominated movie 127 Hours, James Franco and two ladies jump into a water hole, and all I could think was, “Danger! N. fowleri!"

The incubation period is less than two weeks, and initially the sense of smell and taste can change. Then meningitis symptoms come on quickly: neck stiffness and pain, headache, fever, and nausea/vomiting. A lumbar puncture (a needle in the lower back into the sheath that surrounds the spinal cord) is done to examine the cerebral spinal fluid, and the results appear to be bacterial meningitis. Of course, it's not that, and it doesn’t respond to antibiotics.

N. fowleri causes major destruction of the brain, leading to seizures, movement disorders, confusion, and coma. Death is inevitable within four to six days due to increased pressure inside the skull that smooshes the brain.

Though medicines haven’t been shown to save lives, antifungals and antimicrobials are administered to try to kill this horrible amoeba. How do we know when it's N. fowleri? The amoeba is visible in the CSF under a microscope.  

One of the most puzzling things about N. fowleri is that many healthy persons in endemic areas test positive for antibodies to this amoebia. That means they've been exposed to it but didn’t get meningoencephalitis (meningitis and brain infection). Folks exposed to N. fowleri have a history of indulging  in water sports in lakes, ponds, or inadequately chlorinated swimming pools.  

Acanthamoeba is another amoeba– this one found in soil, dust, air conditioners, water, sewage, and contact lens fluid. The meningoencephalitis is slower to manifest than that of N. fowleri, but it's also ultimately fatal within two months when it infects the brain. It tends to affect folks with weak immune systems. 

Now the eye is different matter. In 2007, Acanthamoeba eye infection was detected in 138 people who used a specific brand of contact lens cleaning solution. This led to three months of treatment to spare the eye from pain and blurry vision.

Amoebic infections are rare but horrendous. Perhaps what's happened is that's how nefarious people like Hitler and Attila the Hun have been reincarnated!
Dr. Hook cracks a joke or two, but he's a respected physician with an interesting website,  Email him with your questions.