B60.2 Naegleriasis

Name of the Condition

• Naegleriasis

Summary

Naegleriasis is a rare and severe brain infection caused by the free-living amoeba Naegleria fowleri. It primarily affects the central nervous system and progresses rapidly, often leading to fatal outcomes if not treated promptly. The infection is typically acquired through exposure to contaminated water.

Causes

The condition is caused by Naegleria fowleri, an amoeba found in warm freshwater environments such as lakes, rivers, and hot springs. Infection occurs when contaminated water enters the body through the nose, allowing the amoeba to travel to the brain.

Risk Factors

• Exposure to warm freshwater sources, particularly during swimming or diving.
• Nasal irrigation with contaminated tap water.
• Activities that involve submersion of the head in freshwater, increasing the risk of water entering the nasal passages.

Symptoms

• Severe headache
• Fever
• Nausea and vomiting
• Stiff neck
• Altered mental status or confusion
• Seizures
• Hallucinations

Diagnosis

Diagnosis involves detecting Naegleria fowleri in cerebrospinal fluid (CSF) through microscopic examination or molecular testing. Imaging studies may show brain inflammation, but definitive diagnosis requires laboratory confirmation of the amoeba.

Treatment Options

Treatment focuses on antimicrobial therapy, including miltefosine, and supportive care to manage symptoms. Early intervention is critical, though outcomes remain poor due to the infection's rapid progression.

Prognosis and Follow-Up

Prognosis is generally poor, with high mortality rates even with treatment. Survivors may require long-term neurological rehabilitation. Follow-up care involves monitoring for residual neurological deficits and providing supportive services.

Complications

• Cerebral edema (swelling of the brain)
• Seizures
• Coma
• Death

Lifestyle & Prevention

• Avoid swimming in warm, stagnant freshwater during peak amoeba activity (summer months).
• Use nose clips or hold the nose shut when swimming in freshwater.
• Use sterile, distilled, or boiled water for nasal irrigation.
• Avoid submerging the head in untreated water sources.

When to Seek Professional Help

Seek immediate medical attention if experiencing severe headache, fever, or neck stiffness after freshwater exposure, as these symptoms may indicate early infection.

Tips for Medical Coders

Document the specific clinical presentation, including exposure history and diagnostic findings, to support accurate coding. Ensure the code B60.2 is assigned when Naegleria fowleri infection is confirmed, with clear linkage to the patient's symptoms and test results.