A 15-year-old male was diving in a lake when he inhaled some of the stagnate water. Five days later he was admitted to the hospital, comatose, and in critical condition. A cerebrospinal fluid (CSF) specimen was taken, and several motile amoebae were observed. The patient would most likely be diagnosed with which of the following conditions?
a. Granulomatous amebic encephalitis
b. Primary amebic meningoencephalitis
c. Secondary amebic encephalitis
d. Chronic granulomatous meningitis
B
Naegleria fowleri trophozoites can be found in water or moist soil. The amoebae may enter the nasal cavity by the inhalation or aspiration of water, dust, or aerosols containing the trophozoites or cysts. N. fowleri is incapable of survival in clean, chlorinated water. After inhalation or aspira-tion, the organisms then penetrate the nasal mucosa, probably through phagocytosis of the olfac-tory epithelium cells, and migrate via the olfactory nerves to the brain, causing a primary amebic meningoencephalitis.
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