诊断
病史结合病原学检查可作早期诊断,一般以脑脊液或病灶(皮肤、角膜)涂片染色或接种到琼脂培养基(45 ℃,3~5天)观察阿米巴。尸体解剖可作脑病理切片确诊。
left. Naegleria trophozoites in brain. The nucleoli appear as darkly stained dots in the cytoplasm of the trophozoites. H and E. ×800. Enlarged by 5.4.
right. Naegleria infection is generally associated with haemorrhage in the brain. In the center are trophozoites surrounded with such haemorrhagic areas. H and E. ×400. Enlarged by 5.4.
Naegleria trophozoites in brain showing ingested red cells. H and E. ×1000. Enlarged by 5.4.
耐格里属阿米巴病人脑组织切片
防治原则
目前尚无理想的药物,两性霉素B对福氏耐格里阿米巴病有效,国外已有治疗成功的病例;磺胺嘧啶,庆大霉素对棘阿米巴病有效,但病死率仍然极高。对于棘阿米巴角膜炎,施行角膜移植虽可治愈大部分病例,但术后常有复发,故术前应给予抗阿米巴药物治疗。
应避免在不流动的或温热的水中游泳,加强水源(包括游泳池水)的管理。