RESUMEN
Primary amoebic meningoencephalitis is a rare fatal meningitis caused by free living amoeba Naegleria fowleri, found in freshwater ponds and lakes. It infects children and young adults with exposure due to swimming or diving. We report a case of N. fowleri meningitis in a 6‑year‑old boy who presented with signs and symptoms of acute bacterial meningitis. No history of travelling or swimming was present. However, the boy frequently played with water stored from a “kuhl” (diversion channels of water). Wet mount of cerebrospinal fluid (CSF) revealed amoeboid and actively motile flagellate forms of trophozoites. CSF culture done on 1.5% non‑nutrient agar plates with a lawn culture of Escherichia coli kept at 37°C for 15 days did not reveal any growth. The test of flagellation on passing CSF in distilled water was however positive in 3 h. Water of the “kuhl” from the stored tank also showed actively motile trophozoites similar to the forms obtained from the CSF. Based on our reports, the boy was immediately treated with amphotericin B, rifampicin and fluconazole for 21 days. Repeat CSF examination after 14 days did not reveal any trophozoites in wet mount and patient was discharged after 3 weeks of successful treatment.
RESUMEN
Macrolide antibiotics are well established class of antimicrobial agents. Azithromycin due to better tolerance and once a daily dose is commonly prescribed by clinician today. The aim of our study was to analyze the resistance to erythromycin in all gram positive bacteria isolated in department of microbiology Dr. RPGMC Tanda. A result of antibiotic susceptibility testing done by Kir By bauer disc diffusion method were analysed, Of the totral gram positive isolates 54 % were resistant to Azithromycin with maximum resistance seen with Enterococcus species (75 %) . It is recommended that an antibiotic policy should be made and microbiological surveillance cotinued so as to decrease the selective pressure on microorganisms.