Survey of naegleria fowleri the causative agent of Primary Amoebic Meningoencephalitis (PAM) in stagnant waters around factory area in Thailand.

Naegleria fowleri a free-living amoeba commonly found in moist soil and fresh water, enters the body via the nasal mucosa and migrates along the olfactory nerve to the brain, where it causes fulminant meningoencephalitis that is generally fatal. From 1988 to 1992, a survey of pathogenic Naegleria sp. was carried out in the industrial areas of three provinces. Water samples from warm and fresh ponds were collected from Pathumthani (34 samples), Samutprakan (150 samples) and Lopburi (162 samples). AII specimens were cultured in non-nutrient agar Escherichia coli media (NNE) AT 37oC. The amoebae obtained from water samples were in amoeboid, flagellate and cyst form. The amoeboflagellate transformation was occurred in distilled water and amoebae saline. The amoebae from water samples in Pathumthain (70.59 per cent) and Samutprakan (69.30 per cent) were cultured in Chang’s axenic media (SCGYEM) at 37oC. Non-pathogenic and pathogenic Naeglenia sp were distinguished by the characteristics of growth properties since the pathogenic form can grow only in the SCGYEM axenic media. The percentage of amoebae from Pathumthani and Samutprakan in SCGYEM axenic media at 37oC. were 11.46% and 12.00% respectively. The amoebae from Lopburi cultured in NNE 45oC (10.49 per cent) was inoculated through nasal cavity of Rattus rattus. The result was 10.49 per cent of the amoebae also determined for the virulence and the rats were died in 5-7 days. The histological studies of mouse brain tissue sections revealed the large central karysome and halo around the nucleus of the organisms, the amount of amoebae were accumulated around perivascular space. The characteristics, pathogenicity and pathology of pathogenic Naegleria sp. are the same as Naegleria fowleri.

An in vitro study on mefloquine/quinine in Plasmodium falciparum malaria.

An in vitro designed for determining sensitivity of Plasmodium falciparum strains isolated from Kanchanaburi Province, to Mefloquine/Quinine combination, was carried out. The MIC values of Mefloquine/Quinine for the P.falciparum strains were found to be 0.075/3.75 to 0.225/11.15 nM/ml. The changes observed following the drug treatment were an enlargement of the space between the outer and the inner limiting membrane of the parasitophorous vacuole. These changes were followed by cytoplasmic degeneration and vacuolation.

The fifth nonlethal case of primary amoebic meningoencephalitis.

The fifth nonlethal case of primary amoebic meningoencephalitis was reported. He was a 61-year-old gardener from northeast Thailand who had an abrupt onset of high fever, headache and stupor. Lumbar puncture showed numerous naegleria in the cerebrospinal fluid. The combination of 0.5 mg/kg/day of intravenous amphotericin B for 14 days, oral rifampicin and oral ketoconazole for 1 month cured the patient with no recurrence after one year of follow-up. The authors emphasise the regimen of low dose amphotericin B for a prolonged period instead of a high dose over a short period.

Intestinal parasitosis in the monks and novices at kanmphaeng saen district, nakhon pathom province.

In September 1988, the authors examined 173 fecal specimens of the monks and novides at Kamphaeng Saen Mong College, Kamphaeng Saen District, Nakhon Pathom Province, central Thailand, 56 km from Bangkok. The presence of parasites was found in 48.56% of apecimens examined. These were hookworm Opisthorchis viverrini, Strongyloides stercoralis Echinostome eggs, Tania eggs, Trichuris trichiura, Blastocystis hominis, Entamoeba coli, Giardia lamblia, Trichomonas hominids, and Fntamoeba histolytic encountered in 12.39%, 17.34%, 8.6%, 2.31%, 1.16%, 0.58%, 7.51, 4.62%, 4.05%, 1.16 and 0.58% restively. Praziquantel 40 mg/lg and niclosamide 2 gm were given in single dose orally for the fluke infections and taeniasis respectively. Metronidazole 400 mg and 700 mg thrice daily for 7 and 10 days were also given for fiardiasis and amoebiasis respectively.

Primary amoebic meningoencephalitis in Thailand: report of a case and review literatures.

Primary amoebic meningoencephalitis (PAM) which is caused by free-living amoeba, Naegleria fowleri, is a rare disease. We report the fifth case in Thailand in order to add more information. The patient was a previously healthy 4 1/2-year-old girl from Nakhon Pathom province. For several weeks before this illness she had swum in a water supply canal. She developed high fever with change in consciousness. Her cerebrospinal fluid contained numerous Naegleria fowleri which grew in culture media and mice inoculation. She did not respond to treatment with intravenous and intraventricular amphotericin B, and oral rifampicin. She died on the fifth day of illness. Water sample from the canal also grew N. fowleri. All five reported cases in Thailand were reviewed. It was found that none of them had been exposed to a common source. Four of the five cases were male, and four cases occurred during the summer months, March to May. These findings agree with worldwide information.

Primary amoebic meningoencephalitis: a first reported case in Thailand.

A case of primary amoebic meningoencephalitis caused by Naegleria, from Sisaket province of Thailand is first reported. A 5-year old Thai with boy a history of swimming in a pond along a rice field before the onset of this illness, was admitted to the provincial hospital for chief complaints of headache, high fever, vomiting and drowsiness for 4 days. On admission he had convulsions and became comatosed with signs of meningeal irritation. The cerebrospinal fluid was similar to pyogenic meningitis but numerous amoebae were found and identified as Naegleria sp. Unfortunately, specific treatment was not administered promptly, the patient died 3 days after admission.

Isospora belli infection as a cause of diarrhoea.

A case of Isospora belli infection in Thailand is reported. An 18 month-old Thai girl from a foster home was hospitalized for acute mucous diarrhoea. Immature oocysts of I. belli were detected in the stool examination by simple saline smear. The symptoms subsided spontaneously with the disappearance of parasite from the stools on the fifth day. The pathogenesis of mucous diarrhoea and the route of transmission was discussed.

Cysticercus racemosus in the fourth ventricle: report of two cases.

Two cases of cysticercosis of the racemosus type found in the fourth ventricle of the brain are presented. The symptoms were blurred vision or loss of consciousness and increased intracranial pressure. The condition recurred several times in one patient in whom repeated operations to remove the cysts were required.