PathWays Case Study: May 5


A 10-year-old male presented to the emergency room with a two-day history of flu-like symptoms, as well as dizziness, confusion, a headache, and double vision. The patient had a recent history of camping and lake swimming in the Midwest in July. Due to the meningitis-like symptoms, a spinal tap was performed.

Your Score:  

Your Ranking:  


Lisa Hartzheim, MT (ASCP)
Education Program Coordinator
Department of Laboratory Medicine and Pathology
Mayo Clinic
Instructor in Laboratory Medicine and Pathology,
Mayo Clinic College of Medicine



Mechelle Miller

Mechelle Miller, BS, MT, MLT (ASCP)
Technical Specialist
Department of Laboratory Medicine and Pathology
Mayo Clinic



April Josselyn

April Josselyn is a Marketing Associate at Mayo Medical Laboratories. She is the editor of Mayo Clinic PathWays and supports corporate communications strategies and internal communications. She has worked at Mayo Clinic since 2012. Outside of work, April enjoys the outdoors and being "hockey mom" for her two sports-crazed boys.


Did the boy survive?

excellent case

Thanks for the beautiful amoaba pictures!

Hope i am ok

These are very interesting. Thanks.

Great case!

I love these cases, it’s great to keep the brain in gear! Thank you.

Great case, but also wondering if the child survived. Is there any documentation whether swiftness of diagnosis has any bearing on outcome?

Thank you.Always helpful to revisit such rare cases and refresh the memory.

Actually it is not the history or phenotype but size (leukocytes..infectious agent) comparison that led..

Interesting case and fabulous photography! Thanks for sharing it.

Thank you for a challenging case study. In South Africa, Amoebiasis is common in rural populations due to ingestion of contaminated food or water and causes hepatic abscesses. However, we see amoebic meningitis in HIV / AIDS, or immunocompromised patients on chemotheraphy or in T2 diabetic patients. I wonder if this child is immunocompromised or nutritionally deficient?
I will use your case study with my clinical students, if I may. Thank you, once again.

Please feel free to moderate my input, as deemed necessary. Thank you, look forward to more stimulating clinical case studies

SAST 2106 hours on Tuesday, 5th May 2015

Acanthamoeba is also a more common possibility. Cases of Acantamoebic Keratits have been described in Great Britain from people using tap water for their contact lenses.

Interesting case, hope to see more of these to help me recall what Ive studied before.

Thank you for the interesting case which I shared with my colleagues in theLab. Some years ago, at the Children Hospital “Aghia Sophia” ,Athens-Greece, we had diagnosed a simular case in a child 6 years old with a succesfull outcome . I am wondering what is the outcome of this case.

Very stimulating! Did the child survive? What is/was the correct treatment?

Thank you for the question regarding our PathWays case of Naegleria fowleri infection. Unfortunately, this patient did not survive. This type of infection is almost universally fatal, with only a few patients in the world who have survived. It is important to be able to recognize the appearance of Naegleria trophozoites in cerebrospinal fluid so the patient can receive prompt treatment (reference:

Thank you for sharing.

challenging case

Great case. Good pictures. Thanks

I. Haven’t forgotten everything . I miss the lab.retired 5 years. Thanks

Comments are closed.