Naegleria fowleri. Naegleria fowleri ( Fig. 7.

13 ) is also known in some literature

as N. aerobia. It is the major cause of a disease called primary amebic
meningoencephalitis (PAM). Other known species, N. gruberi, N. lovaniensis, and N.
australiensis, apparently are harmless. Flagellated stages of N. fowleri bear two long
flagella at one end, are rather elongated, and do not form pseudopodia; ameboid stages
usually have one blunt pseudopodium although pointed tips are visible by scanning
electron microscope ( Fig. 7.14 ).
Transformation from ameboid to flagellated form is quite rapid; once flagella
develop, the organisms can swim rapidly. Their nucleus is vesicular and has a large
endosome and peripheral granules. Dark polar masses are formed at mitosis, and
Feulgen-negative interzonal bodies are present during late stages of nuclear division. A
contractile vacuole is conspicuous in free-living forms. Food vacuoles contain bacteria
in free-living stages but are filled with host cell debris in parasitic forms.
Sucker like structures called ameba tomes are present; at least in culture forms
ameba tomes function in phagocytosis (see Fig. 7.14). 29 The cyst has a single
nucleus. • Primary Amebic Meningoencephalitis (PAM). This is an acute, fulminant,
rapidly fatal illness usually affecting children and young adults who have been exposed
to water harboring free-living N. fowleri. Most cases are contracted in lakes or swimming
pools. Flagellated trophozoites probably are forced deep into the nasal passages when
a victim dives into the water.
One well documented case involved washing, including sniffing water up his
nose, by a Nigerian farmer. 36 After entrance to the nasal passages, amebas migrate
along olfactory nerves, through the cribriform plate, and into the cranium.Death from
brain destruction is rapid, and few cures have been reported.
The mechanism of pathogenesis is not known, but the amebas produce cytolytic
polypeptides similar to those of E. histolytica. 25 endosome and nuclear membrane,
which has no peripheral granules. Food vacuoles usually contain bacteria and yeasts.
The precyst is usually oblong and contains no undigested food. It secretes the cyst wall
that also is usually oblong, measuring 6 μm to 15 μm long. The mature cyst ( Fig. 7.12;
see Fig. 7.11 ) nearly always has only one nucleus.
A large conspicuous glycogen vacuole stains deeply with iodine—hence the
generic name. • Biology. Iodamoeba buetschlii lives in the large intestine, mainly in the
cecal areas, where it feeds on intestinal flora. Infection spreads by contamination, since
mature cysts must be swallowed to induce infection. It is possible that humans become
infected through pig feces as well as human feces. A few reports of I. buetschlii causing
ectopic abscesses like those of E. histolytica probably were actually misidentifications of
Naegleria fowleri.