{"id":4509,"date":"2013-08-25T11:05:48","date_gmt":"2013-08-25T15:05:48","guid":{"rendered":"http:\/\/blogs.nejm.org\/?p=4509"},"modified":"2015-06-04T14:33:13","modified_gmt":"2015-06-04T18:33:13","slug":"death-from-brain-eating-parasite-a-reminder-of-how-little-we-really-know","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/death-from-brain-eating-parasite-a-reminder-of-how-little-we-really-know\/2013\/08\/25\/","title":{"rendered":"Death from “Brain-Eating Parasite”: A Reminder of How Little We Really Know"},"content":{"rendered":"

\"naegleria<\/a> <\/p>\n

Sometimes it takes a lot to surprise an ID doctor — we who try to make it seem like we’ve seen it all — but certain infections are either so severe (e.g., necrotizing fasciitis from group A strep) or so rare (e.g., endocarditis from\u00a0Erysipelothrix rhusiopathiae<\/em>) that even we are startled.<\/p>\n

Doubly startling are those infections that score 10 out of 10 on both the severity and<\/em> the rarity scale.<\/p>\n

No doubt one such condition is primary amebic meningoencephalitis (PAM), the brain infection that tragically just led to the death of a 12-year-old boy in Florida<\/a>.<\/p>\n

The pathogenesis of PAM is straightforward:<\/p>\n

    \n
  1. Naegleria fowleri\u00a0<\/em>live in warm freshwater lakes and ponds.
    \n<\/span><\/li>\n
  2. The parasite enters the body through the nose, usually when someone swims or dives in these waters. (Some cases occur when contaminated water is used for nasal irrigation<\/a>).<\/li>\n
  3. From the nose, the Naegleria<\/em> travel back into the brain, causing a severe necrotizing infection that is almost invariably fatal.<\/li>\n<\/ol>\n

    However, just because we know how<\/em> it happens, by no means we know why<\/em>\u00a0on an individual level.<\/p>\n

    Said another way, given the millions of people who swim in warm lakes and ponds each year, why have there been only 31 cases from 2003-2012?<\/a> Why did this poor boy get sick, but his friends did not?<\/p>\n

    A case like this is a reminder that, no matter how experienced the clinician, the world of infections and how they cause human disease remains a humbling life’s work.<\/p>\n","protected":false},"excerpt":{"rendered":"

      Sometimes it takes a lot to surprise an ID doctor — we who try to make it seem like we’ve seen it all — but certain infections are either so severe (e.g., necrotizing fasciitis from group A strep) or so rare (e.g., endocarditis from\u00a0Erysipelothrix rhusiopathiae) that even we are startled. Doubly startling are those […]<\/p>\n","protected":false},"author":6,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[3,5,8],"tags":[56,639,691],"class_list":["post-4509","post","type-post","status-publish","format-standard","hentry","category-health-care","category-infectious-diseases","category-patient-care","tag-amebic-meningoencephalitis","tag-naegleria-fowleri","tag-pam"],"post_mailing_queue_ids":[],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts\/4509","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/users\/6"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/comments?post=4509"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts\/4509\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/media?parent=4509"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/categories?post=4509"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/tags?post=4509"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}