张娜, 周艺彪. 福氏耐格里原虫传播特征及防治研究进展[J]. 上海预防医学, 2022, 34(2): 187-191. DOI: 10.19428/j.cnki.sjpm.2022.20636
引用本文: 张娜, 周艺彪. 福氏耐格里原虫传播特征及防治研究进展[J]. 上海预防医学, 2022, 34(2): 187-191. DOI: 10.19428/j.cnki.sjpm.2022.20636
ZHANG Na, ZHOU Yibiao. Transmission characteristics and prevention measures of Naegleria fowleri: a review[J]. Shanghai Journal of Preventive Medicine, 2022, 34(2): 187-191. DOI: 10.19428/j.cnki.sjpm.2022.20636
Citation: ZHANG Na, ZHOU Yibiao. Transmission characteristics and prevention measures of Naegleria fowleri: a review[J]. Shanghai Journal of Preventive Medicine, 2022, 34(2): 187-191. DOI: 10.19428/j.cnki.sjpm.2022.20636

福氏耐格里原虫传播特征及防治研究进展

Transmission characteristics and prevention measures of Naegleria fowleri: a review

  • 摘要:
    目的 对福氏耐格里原虫以及原虫引起的原发性阿米巴性脑膜脑炎进行综述,加强公众对疾病的认知与防范意识。
    方法 查阅文献、资讯报道等途径收集信息,分别从流行现状、生活史、形态、环境分布、感染途径、发病机制、临床表现、诊断、治疗和防控措施等方面进行概述。
    结果 原发性阿米巴性脑膜脑炎是一种由福氏耐格里原虫引起的水源性疾病,虫体经由鼻腔进入人体,穿过嗅神经进入中枢神经系统,导致出血坏死性脑膜炎。此病虽罕见,但病死率高达95%。大多数报告的患者为健康的儿童或青年人,且在首次症状出现前1周鼻腔接触过被福氏耐格里原虫污染的水体。目前,可将其发病机制简单分为接触性机制和非接触性机制。在接触性机制中,福氏耐格里原虫依靠其表面食物杯的吞噬作用以及释放细胞溶解分子直接破坏宿主细胞。在非接触机制中,福氏耐格里原虫通过分泌的蛋白质发挥毒性作用。临床症状呈爆发性,从发病到死亡的平均时间为5 d,初期表现为头痛、呕吐、发烧等流感样前驱症状,随后表现为中枢神经系统症状,如颈强直、嗜睡、厌食、恐惧等。静脉或者鞘内注射两性霉素B是治疗该病的基础,并且可以联合其他辅助治疗,如脑室内分流和降温,减轻脑水肿。
    结论 阿米巴性脑膜脑炎是一种罕见但致死率高的疾病,未来不仅需要加强公众对疾病的认知与防范意识,特别是避免鼻腔接触污染水,还应加大科研力度,提高诊断水平,研制有效药物,防患于未然。

     

    Abstract:
    Objective To review the Naegleria fowleri and primary amoebic meningoencephalitis caused by the naegleria fowleri, so as to strengthen the public awareness of the disease and its prevention.
    Methods We reviewed the literatures and reports, and summarized the following information: epidemic status, life cycle and characteristics, environmental distribution and infection routes, pathogenesis and clinical manifestations, diagnosis and treatment, prevention and control measures.
    Results Primary amoeba meningoencephalitis is a water-borne disease caused by the Naegleria fowleri, which enters human body through the nose and arrives at the central nervous system through olfactory nerve, leading to hemorrhagic and necrotic meningitis. Although the disease is rare, it has a fatality rate of 95%. Most of the patients reported were healthy children or young adults who had nasal contact with water contaminated with Naegleria fowleri a week before symptoms appeared. At present, its pathology can be divided into contact mechanism and non-contact mechanism. In contact mechanism, the Naegleria fowleri relies on the phagocytosis of food cup on its surface and the release of cytolytic molecules that directly destroy host cells. In non-contact mechanism, the Naegleria fowleri has toxic effects by secreting proteins. The clinical symptoms are episodic, with an average time of five days from illness to death. At beginning, the symptoms may include headache, vomiting, fever and other influenza-like symptoms, followed by central nervous system symptoms, such as stiff neck, drowsiness, anorexia, fear and so on. Intravenous or intrathecal injection of amphotericin B is considered to be the basic treatment of this disease, which can be combined with other adjunct therapies such as ventricular shunt and cooling to reduce encephaledema.
    Conclusion Primary amoebic meningoencephalitis is a rare but highly fatal disease. We should strengthen the public awareness of the disease and its prevention, especially to avoid nasal contact with contaminated water. We should also strengthen scientific research, improve the level of diagnosis, and develop effective drugs to prevent the disease before it happens.

     

/

返回文章
返回