Pathogenic Free Living Amoeba

Parasitology Department
Medical Faculty of Universitas
Sumatera Utara
 Small free living amebas.

Facultative parasite of the genus:

1. Naegleria
2. Acanthamoeba

Occurs worldwide (ubiquitous)

Have been isolated from a variety
of habitat including:
water, soil and air.

Infection by them are rare but

usually very dangerous, often
physicians, pathologists,
laboratorians still unfamiliar with
them
Naegleria fowleri
- An amoeboflagellate &
human pathogen
- Causes Primary Amebic
Meningoencephalitis (PAM)
- Thermophilic, tolerating temp
of 40 - 45 C
3 stages in life cycle:

i. Trophozoite
ii. Cyst
iii. Temporary flagellate
stage
 Trophozoite
- rapidly motile & moves with broad,
large lobopodia
- size 10-20 um
- uninucleate with large karyosome
surrounded by a halo
- contractile vacuole present
- The trophozoites replicate by promitosis
(nuclear membrane remains intact)
- is the only stage found in human
- multiplies rapidly in favourable
condition:
 non-nutrient agar seeded with E. coli
 peptone yeast extract broth
 mamalian tissue culture
Cyst
- round, smooth thin double
wall, size 10um
- single nucleus, no glycogen
or chromatoid bodies
- low resistance to dessication
- not seen in clinical specimen
Flagellate stage

- Temporary stage when put into

distilled water
- Allows spread of organisms to
fresh pools when it rains
- Changes back to amoeboid stage
after few hours
 Sources for Naegleria
 Soil
 Sewage sludge
 Nasal & throat swabs
 Water – fresh and brackish
- tap water, lakes, stream, ponds
- swimming pools, hydrothermal
pools, thermal springs, cooling tower,
thermally polluted water, sewage
wastes
 EPIDEMIOLOGY
 Cases reported worldwide and at least 200
cases of PAM reported
 Mostly fatal
 Australia highest number
 Young active, healthy individual
 Equal in both sexes
 History of swimming/diving in warm
waters
 More prevalent in warm summer months
 Transmision
 Nasal instillation
 Organism enters host’s nasal cavity &
infects the mucous membranes and the
paranasal sinuses.
 Then the trophozoites penetrate the
cribriform plate and follow the olfactory
nerve to the brain where they multiply &
may be isolated from the CSF
 Transmission via inhalation of contaminated
dust is possible
 ACANTHAMOEBA
 Free living amoeba widely distributed in
nature
 Facultative parasite of man and animal
 Causes infection :
1. CNS (Granulomatous Amebic
Encephalitis GAE)
2. Cornea (Keratitis)
3. Skin ulcers
Recent increase in the number
of cases of CNS infection as
well as cases of keratitis

Problems with diagnosis and

effective treatment
 Morphology

 Present in only 2 stages ie.

Trophozoite and cyst
 No flagellate stage
 Trophozoite
 Trophozoite larger than Naegleria (16-
40um)
 Pocess spikelike pseudopodia called
Acanthopodia (spine) and moves very
slowly
 Trophozoite has single nucleus with large
karyosome
 Contractile vacuole actively contracting
- multiplies rapidly in favourable
condition
 non-nutrient agar seeded with E. coli
 peptone yeast extract broth
 mamalian tissue culture
- Infective stage:
 The trophozoites are the infective forms
 Entry into the body through:
 Lower respiratory tract
 Ulcerated or broken skin
 Invade the CNS by hematogenous
dissemination

 Trophozoites are found in the tissue

Trofozoit Acanthamoeba spp.

vakuol kontraktil

acanthapodia

Rajah 4.1Trofozoit
 Cyst
 Various sizes among species (8-18um)
 Various shapes (angular, wrinkled, starlike)
 Posess pores (ostioles/ like star light)
 Thick double wall (endo and ectocyst)
 Very resistant to external environment and
disinfectant, can be carried in water and
air
 Risk factors
 Contact lens wear esp. extended wear
 Trauma to the eye
 Use of home made saline
 Use of tap water to rinse lens
 Swimming while wearing CL
 Poor hygienic care of CL system
 Other specimens include contact lens,
CL casing, CL saline and disinfectant,
tap water used to rinse lens

 The specimens should also be cultured

for Acanthamoeba using NNA overlay
with E. coli

 Examine under inverted microscope

daily until 14 days before a negative
result is confirmed