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The patient, a 44-year-old man, went to the emergency department after a day of confusion and coughing.
, he had been swimming in an indoor pool in India.
, his temperature was 39.8 degrees Celsius and his heart rate was 120 per minute.
he didn't answer questions and blinked at visual threats.
, however, the brain-dry reflex was intact, and he retracted his arms and legs from the painful stimulation.
he had no neck stiffness or rash.
lumbar pus pus (shown in Figure A) was found to have 2,083 nucleocytes per cubic millimeter (91 per cent neutral granulocytes) and glucose levels of 87 mg/dL (4.8 mmol) /L) (Reference ranges from 40 to 70 mg/dL (2.2 to 3.9 mmol/L) and protein levels from 477 mg/dL (reference range 10 to 45 mmol/L).
the patient began receiving an experienced antibiotic treatment for bacterial meningitis;
tested the cerebrospinal fluid with Wright-Giemsa chromosomes and found that the nourishing body was consistent with amoeba (figure B).
polymerase chain reaction assay was determined to be Foch Negri amiba.
, which is usually associated with summer and fresh water, can cause primary amiba meningitis, although there have been few surviving cases.
the patient died five days after treatment for both sexes mycomycin, lyphopine, fluconazole, azithromycin and methafosin.
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