4. November 2024

Naegleria fowleri-infeksjon (hjernespisende amøbe).

 

http://mednorge.com/naegleria-fowleri-infeksjon-hjernespisende-amobe

 

Naegleria fowleri-infeksjon (hjernespisende amøbe)

Oversikt

Naegleria-infeksjon er en sjelden og nesten alltid dødelig hjerneinfeksjon. Naegleria-infeksjon er forårsaket av en amøbe som ofte finnes i varme ferskvannssjøer, elver og varme kilder. Eksponering for amøben skjer vanligvis under svømming eller annen vannsport.

Amøben – kalt Naegleria fowleri – reiser opp nesen til hjernen, hvor den forårsaker alvorlig hjerneskade. De fleste som har naegleria-infeksjon, dør innen en uke etter å ha vist symptomer.

Naegleria fowleri (ofte referert til som “hjernespisende amøbe”)

Hvert år blir millioner av mennesker utsatt for amøben som forårsaker naegleria-infeksjon, men bare noen få blir smittet. Helsepersonell vet ikke hvorfor noen utvikler naegleriainfeksjon, mens andre ikke gjør det.

Symptomer på naegleria infeksjon

Naegleria-infeksjon forårsaker en sykdom som kalles primær amebisk meningoencefalitt – også kjent som PAM. PAM er en hjerneinfeksjon som fører til hevelse i hjernen og ødeleggelse av hjernevev.

Symptomene på naegleria-infeksjon begynner vanligvis innen to til 15 dager etter eksponering for amøben. Innledende symptomer inkluderer ofte:

  • Feber
  • Plutselig, alvorlig hodepine
  • Kvalme og oppkast
  • Tett nese eller utslipp
  • Endringer i lukt eller smak

Når sykdommen forverres, kan symptomene også omfatte:

  • Stiv nakke
  • Følsomhet for lys
  • Forvirring
  • Tap av balanse
  • Søvnighet
  • Beslag
  • Hallusinasjoner

Denne sykdommen kan utvikle seg raskt og fører vanligvis til døden innen omtrent fem dager etter at symptomene startet.

Omfattende blødning og nekrose er tilstede i hjernen, hovedsakelig i frontal cortex.
Omfattende blødning og nekrose er tilstede i hjernen, hovedsakelig i frontal cortex.

Når trenger du å oppsøke lege?

Søk øyeblikkelig lege hvis du får en plutselig feber, hodepine, stiv nakke og oppkast, spesielt etter at du nylig har vært i varmt, ferskvann.

Fører til

Naegleria-infeksjon er forårsaket av Naegleria fowleri amoeba, som oftest finnes i kropper av varmt, ferskvann rundt om i verden, spesielt i sommermånedene. Denne amøben finnes også noen ganger i jord. Denne amøben kommer inn i kroppen din gjennom nesen din via forurenset vann, gjørme eller støv, og reiser til hjernen din gjennom nervene som overfører luktesansen.

Bare en liten prosentandel av millionene av mennesker som blir utsatt for Naegleria fowleri blir noen gang syke av det. Hvorfor noen blir smittet etter eksponering, og andre ikke er kjent.

Amøben sprer seg ikke fra person til person. Du kan heller ikke bli smittet av å drikke forurenset vann. Saltvann, som hav- og sjøvann, og riktig rengjørte og desinfiserte svømmebassenger inneholder ikke naegleria amoeba.

Risikofaktorer

Millioner av mennesker blir utsatt for amøben som forårsaker naegleria-infeksjon hvert år, men bare noen få mennesker blir smittet med den.

Disse faktorene kan øke risikoen for naegleriainfeksjon:

  • Svømming i ferskvann. De fleste som har blitt syke har svømmet i en ferskvannssjø de to siste ukene.
  • Hetebølger. Amøben trives i varmt eller varmt vann. Infeksjoner er mer sannsynlig i sommermånedene.
  • Alder. Barn og unge voksne er de mest sannsynlige aldersgruppene som blir berørt, muligens fordi de sannsynligvis blir lenger i vannet og er mer aktive i vannet.
  • Nese rensing. Svært sjelden har det oppstått infeksjoner hos mennesker som brukte forurenset vann fra springen for å vanne bihulene eller for å rense nesen under religiøs praksis. For å sikre at vannet ditt er trygt for sinusskylling eller rituell rensing, må du ikke bruke vann rett fra kranen. Bruk kokt eller destillert vann i stedet.

Forebygging av naegleria-infeksjon

Centers for Disease Control and Prevention (CDC) antyder at følgende tiltak kan redusere risikoen for naegleriainfeksjon:

  • Ikke svøm inn eller hopp i varme ferskvannssjøer og elver.
  • Bruk neseklips når du hopper eller dykker ned i varme ferskvannskilder.
  • Unngå å forstyrre sedimentet mens du svømmer i grunt, varmt ferskvann.

Diagnose av naegleriainfeksjon

Infeksjon med naegleria amoeba bekreftes vanligvis gjennom en laboratorietest av cerebrospinalvæske (CSF). CSF er væsken som omgir hjernen og ryggmargen.

For å få et utvalg av CSF, utfører en lege en lumbal punktering. Under denne prosedyren settes en nål mellom to ryggvirvler i korsryggen. En liten mengde CSF fjernes og sendes til et laboratorium, hvor den undersøkes under et mikroskop for å avgjøre om naegleria amoeba er til stede. En lumbal punktering kan også brukes til å måle cerebrospinalvæsketrykket og se etter betennelsesceller.

En nål fjerner væske fra området rundt ryggmargen
Lumbal punktering. Under en lumbal punkteringsprosedyre vil du ligge på siden med knærne trukket opp mot brystet. En nål settes deretter inn i ryggmargen – mellom to ryggvirvler i nedre rygg – for å samle hjernevæske (CSF) for testing.

Imaging tester

En lege kan bestille bildebehandlingstester, som datastyrt tomografi (CT) eller magnetisk resonansbilder (MR) for å avsløre hevelse og blødning i hjernen.

  • CT skann. Denne prosedyren kombinerer røntgenbilder tatt fra mange forskjellige retninger i detaljerte tverrsnittsbilder.
  • MR. En MR-maskin bruker radiobølger og et sterkt magnetfelt for å produsere ekstremt detaljerte bilder av bløtvev, som hjernen.

Behandling av naegleria infeksjon

Få mennesker overlever naegleria-infeksjon, selv med behandling. Tidlig diagnose og behandling er avgjørende for å overleve.

Den anbefalte behandlingen for naegleriainfeksjon er en kombinasjon av legemidler, inkludert:

  • Amfotericin B, et soppdrepende middel som vanligvis injiseres i en blodåre (intravenøst) eller i rommet rundt ryggmargen for å drepe amøber.
  • Miltefosin (Impavido), et undersøkelsesmedisin som vanligvis brukes til å behandle brystkreft og leishmaniasis, men som også har vist løfte mot naegleria amoeba i laboratorie- og dyreforsøk. Det har også blitt brukt til å behandle infeksjoner med andre typer amøber.
  • Andre soppdrepende medisiner.
  • Antibiotika.

I tillegg til disse legemidlene kan legen din anbefale andre medisiner eller behandlingsalternativer for å håndtere eller redusere hevelse i hjernen.

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