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Beaumont Laboratory

Culture, Acanthamoeba

Acanthamoeba, Naegleria, Balamuthia, Acanthamoeba Naegleria Culture, Antrim #41084, EPIC: LAB5474, SOFT: CXACA

Instructions

To obtain Acanthamoeba agar plates, please call Outreach Customer Service 1-800-551-0488.

Specimen Collection Criteria

Collect: Aseptically obtain one of the following specimens.

  • Cerebrospinal Fluid (CSF) in a sterile collection container.
  • Vitreous fluid in syringe with needle removed.
  • Corneal scrapings inoculated directly onto Acanthamoeba agar plate.
  • Brain or lung biopsy in a sterile collection container. If invasive disease is suspected, a portion of the tissue should be placed in formalin and sent to Anatomic Pathology for evaluation.

Transport specimens to the Laboratory immediately after collection.

Physician Office/Drawsite Specimen Preparation

Arrange for transportation to the Laboratory prior to specimen collection.  A STAT transport is recommended. Courier Services can be contacted at 1-800-551-0488 for STAT transportation. Do not refrigerate or freeze specimens. Maintain specimens at room temperature (20-26°C or 68-78.8°F) prior to transport.

Preparation for Courier Transport

Transport: All specimen types in an appropriate container, at room temperature (20-26°C or 68-78.8°F).

Rejection Criteria

  • Specimens collected in formalin or other preservatives.
  • Specimens on expired or dried media.
  • Specimens in containers that ever contained formalin.

Storage

Specimen Stability for Testing:

Room Temperature (20-26°C or 68-78.8°F): 4-8 hours
Refrigerated (2-8°C or 36-46°F): Unacceptable
Frozen (-20°C/-4°F or below): Unacceptable

Specimen Storage in Department Prior to Disposal:

Refrigerated (2-8°C or 36-46°F): 7 days

Laboratory

Grosse Pointe sent to Royal Oak Microbiology Laboratory for testing.
Royal Oak Microbiology Laboratory.
Troy sent to Royal Oak Microbiology Laboratory for testing.

Performed

Sunday – Saturday.
Results available within 7-10 days.

Reference Range

No Acanthamoeba/Naegleria detected.

Test Methodology

Culture, Microscopic exam.

Interpretation

False negative results may occur if the specimen is improperly collected or stored.

Clinical Utility

This test aids in the diagnosis of granulomatous amoebic encephalitis and conjunctivitis (caused by Acanthamoeba) and primary amoebic meningoencephalitis (caused by Naegleria fowleri).

Clinical Disease

  • Granulomatous amoebic encephalitis, caused by Acanthamoeba spp and leptomyxid amoebae, has an insidious onset and progression of manifestations, occurring during weeks to months, and is more common in immunocompromised persons. Signs and symptoms can include personality changes, seizures, headaches, nuchal rigidity, ataxia, cranial nerve palsies, hemiparesis and other focal deficits. Fever is often low-grade and intermittent. Skin ulcers can be present. The course can resemble that of a bacterial brain abscess.
  • Acanthamoeba also causes conjunctivitis and keratoconjunctivitis, painful vision-threatening diseases of the cornea. (1,2) If not promptly treated, it may lead to corneal ulceration and eventually blindness. There may be secondary invasion of the central nervous system. Epidemiologic studies indicate wearing contact lenses is a major risk factor, with significant risk to those persons using homemade saline solutions to clean contact lenses. N. fowleri, a small free-living amoeba found in fresh and brackish water, is the causative agent of primary amoebic meningoencephalitis (PAM). PAM occurs generally in patients who had contact with freshwater (i.e. swimming in lakes) 7-10 days before the onset of symptoms. Organisms enter through the nasal mucosa and migrate through the olfactory nerves to the brain. Untreated, death occurs 3-10 days after the onset of symptoms.

Epidemiology

The causative organisms of granulomatous amoebic encephalitis are world-wide in distribution and are found in soil, fresh and brackish water, dust, hot tubs, swimming pools, lakes, tap water, heating and air conditioning units, and sewage. PAM occurs in patients with no demonstrable underlying disease or defect (2).

Incubation Period

Naegleria: 3-7 days.
Acanthamoeba: Unknown, but longer than one week.

Transmission

Transmission occurs by direct contact with contaminated water, saline, or soil. The primary focus of infection is the cornea or respiratory tract (Naegleria) (2).

Reference

    1. Visvesvara, G., 2015. Pathogenic and Opportunistic Free-Living Amebae. In: Jorgensen, J.H., et. al. (eds.). Manual of Clinical Microbiology. 11th edition. ASM Press. Washington, D.C.
    2. Roy, S., J. Yoder, M. Beach, and G. Visvesvara, Amebic Infections/Infections with Free-Living Ameba (naegleriasis, acanthamoebiasis, balamuthiasis), 2000. Naegleriasis and Acanthamebiasis, In: Heymann, D.L., ed. Control of Communicable Diseases Manual. 20th ed. Washington D.C., American Public Health Assoc. APHA Press.

      CPT Code

      87081, 87210, 88313.

      Test Codes

      Antrim #41084, EPIC: LAB5474, SOFT: CXACA

      Last Updated

      11/08/2017

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      This directory currently reflects information only for specimens collected and/or processed at the Farmington Hills, Grosse Pointe, Royal Oak, and Troy campuses.