• DOI:10.1093/cid/cir961
• Corpus ID: 17636261

Fatal Naegleria fowleri infection acquired in Minnesota: possible expanded range of a deadly thermophilic organism.

@article{Kemble2012FatalNF,
  title={Fatal Naegleria fowleri infection acquired in Minnesota: possible expanded range of a deadly thermophilic organism.},
  author={Sarah K. Kemble and Ruth Lynfield and Aaron S DeVries and Dennis Drehner and William F. Pomputius and Michael J. Beach and Govinda S. Visvesvara and Alexandre Janu{\'a}rio da Silva and Vincent R. Hill and Jonathan S. Yoder and Li-zhu Xiao and Kirk E. Smith and Richard N. Danila},
  journal={Clinical infectious diseases : an official publication of the Infectious Diseases Society of America},
  year={2012},
  volume={54 6},
  pages={
          805-9
        }
}

• S. Kemble, R. Lynfield, +10 authors R. Danila
• Published 15 March 2012
• Medicine
• Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

BACKGROUND
Primary amebic meningoencephalitis (PAM), caused by the free-living ameba Naegleria fowleri, has historically been associated with warm freshwater exposures at lower latitudes of the United States. In August 2010, a Minnesota resident, aged 7 years, died of rapidly progressive meningoencephalitis after local freshwater exposures, with no history of travel outside the state. PAM was suspected on the basis of amebae observed in cerebrospinal fluid.

METHODS
Water and sediment samples were collected at locations where the patient swam during the 2 weeks preceding illness onset. Patient and environmental samples were tested for N. fowleri with use of culture and real-time polymerase chain reaction (PCR); isolates were genotyped. Historic local ambient temperature data were obtained.

RESULTS
N. fowleri isolated from a specimen of the patient's brain and from water and sediment samples was confirmed using PCR as N. fowleri genotype 3. Surface water temperatures at the times of collection of the positive environmental samples ranged from 22.1°C to 24.5°C. August 2010 average air temperature near the exposure site was 25°C, 3.6°C above normal and the third warmest for August in the Minneapolis area since 1891.

CONCLUSIONS
This first reported case of PAM acquired in Minnesota occurred 550 miles north of the previously reported northernmost case in the Americas. Clinicians should be aware that N. fowleri-associated PAM can occur in areas at much higher latitude than previously described. Local weather patterns and long-term climate change could impact the frequency of PAM.