medical report and coding for patient with primary amebic meningoencephalitis (pam)

by Guiseppe Satterfield 3 min read

Primary Amebic Meningoencephalitis (PAM) - Florida …

17 hours ago 850-245-4444. Florida Health. 4052 Bald Cypress Way. Tallahassee, FL 32399. Naegleria fowleri is the causative agent for Primary Amebic Meningoencepalitis (PAM). It is a freshwater ameba commonly found in the environment worldwide. Most commonly, this ameba is found in warm bodies of fresh water, such as lakes, rivers, and hot springs, warm ... >> Go To The Portal


What is Primary Amebic Meningoencephalitis (PAM)?

Primary amebic meningoencephalitis (PAM) is a serious infection and inflammation of the brain caused by Naegleria fowleri 1, 2. The disease is diagnosed using specific laboratory tests available in only a few laboratories in the United States.

How do you prevent Primary Amebic Meningoencephalitis?

To prevent this type of infection, avoid swimming in untreated freshwater, especially during warm weather when the amoeba grows best. Other prevention measures can include wearing nose clips when swimming in these bodies of water, and avoiding diving as much as possible. What are the symptoms of primary amebic meningoencephalitis?

How do you identify motile amebae in CSF?

The motile amebae can often be seen moving rapidly under a microscope when looking at a fresh sample of CSF. The amebae can also be stained with a variety of stains, such as Giemsa-Wright or a modified trichrome stain, for identification 1, 2. Visvesvara GS.

What is primary amebic meningoencephalitis PAM?

Primary amebic meningoencephalitis (PAM), is a disease of the central nervous system 1,2. PAM is caused by Naegleria fowleri, a free-living ameba. It is a rare disease* that is almost always fatal 3; only 4 people in the U.S. out of 151 have survived infection from 1962 to 2020 4.

How is PAM diagnosed?

PAM and Naegleria fowleri infection can be diagnosed in the laboratory by detecting 3:Naegleria fowleri organisms in cerebrospinal fluid (CSF), biopsy, or tissue specimens, or.Naegleria fowleri nucleic acid in CSF, biopsy, or tissue specimens, or.Naegleria fowleri antigen in CSF, biopsy, or tissue specimens.

Do I have PAM?

Initial signs and symptoms of PAM include headache, fever, nausea, vomiting, and stiff neck. As the ameba causes more extensive destruction of brain tissue this leads to confusion, lack of attention to people and surroundings, loss of balance and bodily control, seizures, and hallucinations.

What is PAM Naegleria fowleri?

Naegleria fowleri (commonly referred to as the “brain-eating amoeba” or “brain-eating ameba”), is a free-living microscopic ameba*, (single-celled living organism). It can cause a rare** and devastating infection of the brain called primary amebic meningoencephalitis (PAM).

How do you treat PAM?

The cornerstone of PAM treatment is amphotericin B deoxycholate (AMB), at maximally tolerated doses, plus miltefosine with adjunctive therapy. The CDC currently recommends the following multidrug regimen: Amphotericin B 1.5 mg/kg/day intravenous (IV) in 2 divided doses for 3 days, then 1 mg/kg/day for 11 days.

What are symptoms of PAM?

Initial symptoms of PAM start about 5 days (range 1 to 9 days) after infection. The initial symptoms may include headache, fever, nausea, or vomiting. Later symptoms can include stiff neck, confusion, lack of attention to people and surroundings, loss of balance, seizures, and hallucinations.

Is PAM contagious?

PAM is not contagious from person to person. The only way to become infected with Naegleria fowleri is for the ameba to reach the tissues far up at the roof of the nasal cavity.

Can PAM be cured?

Conclusions: Early treatment of PAM by i.v. administration of amphotericin B and fluconazole, and oral administration of rifampicin can offer some hope of cure for this devastating disease.

How common is PAM?

PAM is a rare disease* that is almost always fatal. In the United States**, there have been 151 PAM infections from 1962 through 2020 with only four survivors. These infections have primarily occurred in 15 southern-tier states, with more than half of all infections occurring in Texas and Florida.

What is the diagnostic stage of Naegleria fowleri?

Naegleria fowleri has 3 stages in its life cycle: cyst (1), trophozoite (2), and flagellate (3). The only infective stage of the ameba is the trophozoite. Trophozoites are 10-35 µm long with a granular appearance and a single nucleus.

What are the conditions under which PAM survives?

In general, they are sensitive to environmental conditions such as aridity and pH extremes and cannot survive in seawater. In humans, they are found in the throat and nasal cavity. N fowleri is heat-tolerant and is able to survive temperatures up to 45.8°C, pre-adapting the species to mammalian body temperature.

How do you prevent PAM?

To prevent this type of infection, avoid swimming in untreated freshwater, especially during warm weather when the amoeba grows best. Other prevention measures can include wearing nose clips when swimming in these bodies of water, and avoiding diving as much as possible.

When was the PAM case?

In early September 2002 , the Georgia Division of Public Health and CDC were notified about a fatal case of primary amebic meningoencephalitis (PAM) caused by Naegleria fowleri in a boy aged 11 years who had recently swum in a local river. This report summarizes the case investigation. In response to this case, the district health department recommended that local community authorities advise persons to avoid swimming in this river during periods of high temperature and low water depth.

How rare is PAM?

The disease is extremely rare despite the millions of persons with exposure to recreational water. During 1989--2000, CDC's waterborne disease outbreak surveillance system documented 24 fatal cases of PAM in the United States ( 5 ). The majority of these cases occurred during the summer months and among children.

What was the cause of the lumbar puncture?

Lumbar puncture was unsuccessful, and the patient was started on intravenous antibiotics for suspected bacterial meningitis. Within several hours of admission, he had spontaneous nonpurposeful movements, was unable to follow verbal commands, and was transferred to a children's hospital intensive care unit (ICU).

Is PAM a risk factor?

Little is known about the risk factors for infection with PAM. Although these amebae are ubiquitous in freshwater bodies, high water temperatures and decreased precipitation leading to a low river depth might have contributed to proliferation of amebae in this river, subsequently increasing the risk for infection.

Is PAM a fatal infection?

Editorial Note: PAM is a rare but nearly always fatal infection caused by N. fowleri, a thermophilic, free-living ameba that inhabits freshwater ponds, lakes, and rivers, minimally chlorinated pools, and hot springs throughout the world ( 2 ).

What is the name of the nucleic acid in CSF?

Naegleria fowleri nucleic acid in CSF, biopsy, or tissue specimens, or. Naegleria fowleri antigen in CSF, biopsy, or tissue specimens.

What is the name of the disease caused by Naegleria fowleri?

Primary amebic meningoencephalitis (PAM) is a serious infection and inflammation of the brain caused by Naegleria fowleri 1, 2. The disease is diagnosed using specific laboratory tests available in only a few laboratories in the United States. Because of the rarity of the infection and difficulty in initial detection, ...

What is PCR in CSF?

Polymerase Chain Reaction (PCR) Specific molecular tools can amplify DNA from the amebae in CSF or tissue to specifically identify if the amebae are present. Looking at strains or subtypes of Naegleria fowleri can be done, but little is known about the natural populations in the environment, which makes it difficult to interpret what ...

Is Naegleria fowleri a heat loving amebae?

If there are no amebae on the plate grown at the higher temperature, then Naegleria fowleri is not present. If heat-loving (thermophilic) amebae are present on the plate grown at the higher temperature, then these amebae undergo further specific testing to determine whether Naegleria fowleri is present since other free-living amebae can also be ...

Can amebae be grown in culture?

The amebae can be grown in culture to increase the likelihood of detecting the ameba by direct visualization or PCR 1. The sample is added to a growth plate covered in bacteria that can serve as a food source for Naegleria fowleri.

How rare is PAM?

Compared to other conditions such as drowning and other types of meningitis, PAM is very rare. In Texas, from 2004 to 2008, there were 3 cases of PAM, 749 deaths from drowning, and 225 cases of bacterial meningitis.

How long does it take for a person to die from a symtom?

After the start of symptoms, the disease progresses rapidly and usually causes death within about 5 days (range 1 to 12 days).

How does Naegleria fowleri infect humans?

Naegleria fowleri infects people by entering the body through the nose. Generally, this occurs when people swim or dive in warm freshwater, especially stagnant ponds or lakes in warm climate areas. The ameba travels up the nose to the brain and spinal cord where it destroys brain tissue.

What temperature does Naegleria fowleri grow?

Water heaters. Naegleria fowleri grows best at higher temperatures up to 115°F (46°C) and can survive for short periods at higher temperatures. Soil.

How long does it take for Naegleria fowleri to show symptoms?

Initial symptoms of PAM start about 5 days (range 1 to 9 days) after infection.

What is primary amebic meningoencephalitis?

What is Primary Amebic Meningoencephalitis (PAM)?#N#Primary Amebic Meningoencephalitis or PAM is an infection of the brain and the membranous tissues that surround and cover the spinal cord and brain. The causative agent is an ameba ( single-celled organism) called Naegleria fowleri. In very rare situations, Naegleria fowleri has been known to cause infection in humans. The infection progresses rapidly, causing massive destruction of the brain and meningeal tissues, resulting in coma and death usually within 10 days from onset of symptoms. This infection is almost always fatal.

Where can I find Naegleria fowleri?

Naegleria fowleri is commonly found around the world. In the U.S., the majority of infections have been caused by Naegleria fowleri from freshwater located in southern-tier states. The ameba can be found in: Bodies of warm freshwater, such as lakes and rivers. Geothermal (naturally hot) water, such as hot springs.

What is primary amebic meningoencephalitis (PAM)?

Primary amebic meningoencephalitis (PAM) is a disease caused by infection with Naegleria fowleri, a microscopic amoeba commonly called a "brain-eating amoeba." This infection destroys brain tissue, causing severe brain swelling and death in most cases.

What causes primary amebic meningoencephalitis?

PAM typically occurs when people swim in bodies of warm freshwater (such as lakes and streams/rivers) where Naegleria fowleri is present. Very rarely, infection occurs when contaminated water from other sources enters the nose.

What are the symptoms of primary amebic meningoencephalitis?

Initial symptoms of PAM appear ranging from 1 to 9 days after infection, appearing on average 5 days after infection.

What should I do if I suspect my child was exposed to Naegleria fowleri?

First, remember that these infections are extremely rare. The early symptoms of Naegleria fowleri infection are similar to those caused by other more common illnesses, such as bacterial meningitis.