As upper part of nasal cavity (olfactory bulb and Cribriform plate) are invaded by Naegleria before spreading to the adjacent inferior surface of frontal lobe of brain, a CSF or/and a bloody discharge should logically occur at any point after its infection, but didn't find a case report of it on internet.
Free-living amoeba can indeed cause meningitis is individuals who swim in Lakes that harbor these protozoa. As you said they colonize through the cribiform plate in the Etmoid bone. One of the hallmarks of the disease is that evolves rapidly and it is fatal in most of the cases despite aggressive treatment with amphotericine B or rifampicine. In some cases patients can course nasal discharge but it is not a must. The most important diagnostic tool is the identification of Naegleria in CSF using immunoflourescense. For more information: http://www.neurologyindia.com/article.asp?issn=0028-3886;year=2002;volume=50;issue=4;spage=470;epage=2;aulast=Jain
or I recommend the chapter in Mandell Textbook of infectious diseases.
Thanks.....Diagnosis is a different issue that can settle through Real time PCR or IF, I was more interested in any reference to the case or cases where nasal discharge had occurred in very early or late in the course of the disease. Will keep looking cases history on net. Renan thanks again.
Thanks J.Moser, it deatils the protist infection by all three agents but " Nasal discharge" of either CSF or Blood is what i was looking for in any reported cases, thats not mentioned in that manuscript though.
Will keep the search "On"
:)
Two years ago, I had a fetal case in my hospital. My colleague had reported it and published in Korean J Parasitol. 2013 April; 51(2): 203–206.. Your question is reasonable, in our patient, diffusion hemorrhage was found in CSF study, but we did not found bloody discharge.
Thanks Mr.Yuan Ti Lee, I was just wondering the CSF that you are refering to was from sinal tap and not from the nose, if i understood it correct. No discharge from the nose i guess. Logically it should drain a little if not too much of either CSF or blood in the initial phase of the infection.
I will keep all you guys posted if i get any clues.
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