|the stages flagellate, trophozoite and cyst (seen from upper left to lower left to right) of Naegleria fowleri|
Naegleria fowleri is a species of the genus Naegleria, belonging to the phylum Percolozoa. It is a free-living, bacteria-feeding amoeba that can be pathogenic, causing a fulminant brain infection called naegleriasis, also known as primary amoebic meningoencephalitis (PAM). This microorganism is typically found in bodies of warm freshwater, such as ponds, lakes, rivers, and hot springs. It is also found in the soil near warm-water discharges of industrial plants, and in unchlorinated or minimally-chlorinated swimming pools. It can be seen in either an amoeboid or temporary flagellate stage.
Naegleria fowleri is a thermophilic, free-living amoeba. It is found in warm freshwater ponds, lakes and rivers, and in the very warm water of hot springs. As the water temperature rises, its numbers increase. It was first discovered in 1965, and first identified in Australia. N. fowleri occurs in three forms – as a cyst, a trophozoite (ameboid), and a biflagellate. It does not form a cyst in human tissue, where only the amoeboid trophozoite stage exists. The flagellate form can exist in the cerebrospinal fluid.
The cyst form is spherical and about 7-15 µm in diameter. They are smooth, and have a single-layered wall with a single nucleus. Cysts are naturally resistant to environmental factors, so as to increase the chances of survival until better conditions occur. Trophozoites encyst due to unfavorable conditions. Factors that induce cyst formation include a lack of food, overcrowding, desiccation, accumulation of waste products, and cold temperatures. When conditions improve, the ameba can escape through the pore, or ostiole, seen in the middle of the cyst. N. fowleri has been found to encyst at temperatures below 10 °C (50 °F).
The trophozoite is the feeding, dividing, and infective stage for humans. The trophozoite attaches to olfactory epithelium, where it follows the olfactory cell axon through the cribriform plate to brain. This reproductive stage of the protozoan organism, which transforms near 25 °C (77 °F) and grows fastest around 42 °C (106.7 °F), proliferates by binary fission. The trophozoites are characterized by a nucleus and a surrounding halo. They travel by pseudopodia, temporary round processes which fill with granular cytoplasm. The pseudopodia form at different points along the cell, thus allowing the trophozoite to change directions. In their free-living state, trophozoites feed on bacteria. In tissues, they phagocytize red blood cells and white blood cells and destroy tissue.
The flagellate is pear-shaped and has two flagellum. This stage can be inhaled into nasal cavity during swimming or diving. This biflagellate form occurs when trophozoites are exposed to a change in ionic concentration, such as placement in distilled water. The flagellate form does not exist in human tissue, but can exist in the cerebrospinal fluid. Once inside nasal cavity, flagellated form transforms into a trophozoite. The transformation of trophozoite to flagellate occurs within a few hours.
Naegleria fowleri are amoeboflagellates that inhabit soil and water. Compared to other amoeboflagellates, Naegleria fowleri is more sensitive to drying, pH and can not survive in sea water. This amoeba is able to grow best at moderately elevated temperatures making summer month cases more likely. N. fowleri is thermotolerant and is able to survive 45 degrees Celsius. Warm, fresh water with a sufficient supply of bacterial food provide a habitat for amoebae. Man-made bodies of water, disturbed natural habitats, or areas where soil and unchlorinated/unfiltered water are locations where many cases have happened. N. fowleri seems to thrive during periods of disturbance; the flagellate-empty hypothesis explains that Naglerias success may be due to decreased competition from decreased amount of the normal, thermosensitvie protozoal fauna. This hypothesis suggests that Human disturbances, such as thermal pollution increase N. fowleri abundance by removing their resource competitors. Ameoboflagellates have a motile flagellate stage that is designed for dispersal which is advantageous if an environment has been cleared out of competing organisms.
N. fowleri can cause a lethal infection of the brain called naegleriasis (also known as primary amoebic meningoencephalitis (PAM), amebic encephalitis, or Naegleria infection). Infections can occur when water containing N. fowleri is inhaled through the nose, where it then enters the nasal and olfactory nerve tissue, travelling to the brain through the cribriform plate. N. fowleri normally eat bacteria, but when it enters humans, it uses the brain as a food source. It takes 2–15 days for symptoms to appear after N. fowleri amoebas enter the nose. Initial symptoms may include headache, fever, nausea, or vomiting. Later symptoms can include stiff neck, confusion, lack of attention, loss of balance, seizures, and hallucinations. Once the trophozoites ingest brain tissue and symptoms begin to occur, death will usually occur within 1–2 weeks. There is no effective treatment. A person infected with N. fowleri cannot spread the infection to another person.
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