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  #1  
Old 07-17-2011
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Microbiology How do you treat flagellated protozoa in the CSF!

A 25-year old man is brought to the ED after losing consciousness. His neck is rigid, and funduscopic exam reveals papilledema. A spinal tap reveals flagellated protozoa in the CSF. What is the best treatment option for this patient?
A. Amphotericin B
B. Ceftriaxone
C. Vancomycin
D. Bleomycin
E. Cefapime
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Old 07-17-2011
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I think its A or C coz its seems to b naelgeria fowleri encephalitis or acanthameba ...
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Old 07-17-2011
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e cause it crosses BBB
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e, i guess
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I think it is A, InshaAllah.
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Old 07-17-2011
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amphotericin is antifungal
so it must be E.
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Old 07-17-2011
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A - amphotericin might be used as antiprotosoal as well
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Old 07-17-2011
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Warning! B

B. Ceftriaxone
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Old 07-17-2011
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Default It's A

From WIkipedia:

On the basis of the in vitro evidence alone, the CDC currently recommends treatment with Amphotericin B for primary amebic meningoencephalitis, but there is no evidence that this treatment affects outcome.[9]
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Old 07-18-2011
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Acanthamoeba does NOT have a flagelleted state, but N. fowleri does.
This is Naegleria fowleri Primary Amebic Meningoencephalitis.

This is a fatal infection, and if diagnosis is made premortem, intravenous and/or intrathecal amphotericine plus rifampicin treatment should be attempted. N. fowleri is highly sensitive to amphotericine in vitro.
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Old 07-18-2011
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Default A.

Quote:
Originally Posted by ricko335 View Post
A 25-year old man is brought to the ED after losing consciousness. His neck is rigid, and funduscopic exam reveals papilledema. A spinal tap reveals flagellated protozoa in the CSF. What is the best treatment option for this patient?
A. Amphotericin B
B. Ceftriaxone
C. Vancomycin
D. Bleomycin
E. Cefapime
Intrathecal Amphotericin B.
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Old 07-18-2011
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i think its A
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Old 07-18-2011
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A. Amphotericin B
__________________
Learning is like to row your boat upstream, if you stop learning, you will be pushed back by the current.
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Old 07-18-2011
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Quote:
Originally Posted by ricko335 View Post
A 25-year old man is brought to the ED after losing consciousness. His neck is rigid, and funduscopic exam reveals papilledema. A spinal tap reveals flagellated protozoa in the CSF. What is the best treatment option for this patient?
A. Amphotericin B
B. Ceftriaxone
C. Vancomycin
D. Bleomycin
E. Cefapime
its Amphotericine B
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Old 07-18-2011
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The correct answer is A.
The patient has contracted amoebic meningoencephalitis, caused by the protozoa Naegleria fowleri. Transmission occurs in the trophozoite form, often through diving into freshwater, where trophozoites may penetrate the nasal mucosa and ascend to the brain via the cribriform plate. The disease is fatal, and diagnosis is made when organisms in the transient flagellate stage are found in the CSF. Success in treating the disease is low, but has been demonstrated with amphotericin B
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