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Florida teen survives normally deadly N. fowleri infection
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A teenager in Florida is only the fourth person in the past 54 years to survive a normally deadly Naegleria fowleri infection.
Florida Hospital for Children in Orlando said the male patient, aged 16 years, began receiving specialized treatment within hours of being admitted to the ED on Aug. 7 after developing a serious headache while on vacation with his family.
After the patient’s cerebral spinal fluid tested positive for N. fowleri, doctors cooled his body temperature, induced a coma and administered the oral antiparasitic Impavido (miltefosine, Profounda), which was delivered within 12 minutes by the drug’s Orlando-based manufacturer, according to Humberto Liriano, MD, pediatric intensivist at the hospital.
Within 72 hours, the CDC confirmed that the patient’s cerebral spinal fluid was negative for the amoeba, Liriano said during a news conference.
“Since then, he’s done tremendously well,” he said. “We’ve been very optimistic. He’s walking, he’s speaking.”
According to the Florida Department of Health, the patient was likely infected with the so-called “brain-eating amoeba” while swimming in unsanitary water on private property in Broward County.
Cases of N. fowleri infections are rare and occur mainly in the summer, but they are fatal more than 97% of the time, according to the CDC. North Carolina, South Carolina and Texas have all reported fatal cases of N. fowleri infection since June.
Death usually comes within 1 to 12 days after infection, according to the CDC, which said only three patients out of 138 known to be infected with N. fowleri between 1962 and 2015 survived, including two in 2013 whose treatment included miltefosine.
Four states have recently reported cases of N. fowleri infection, which causes amebic meningoencephalitis.
Source: CDC/Govinda S. Visvesvara, PhD
People can become infected by N. fowleri if water containing the amoeba travels up their nose, but they cannot be infected by drinking contaminated water. From the nose, N. fowleri travels to the brain, where it causes primary amebic meningoencephalitis, destroying brain tissue.
According to the CDC, there were 37 infections reported in the United States in the 10 years from 2006 to 2015, including 33 cases where people were infected by contaminated recreational water. The other four people were infected by contaminated tap water — three while performing nasal irrigation, and one on a backyard water slide.
Early symptoms of N. fowleri infection start within 1 to 7 days and include headache, fever, nausea and vomiting. Later, the infection can cause symptoms such as stiff neck, confusion, loss of balance, seizures and hallucinations. – by Gerard Gallagher
Disclosure: Liriano is an employee of Florida Hospital for Children.