Two children in Oklahoma were infected with a rare parasite, Naegleria, which can cause primary amebic meningoencephalitis (PAM):

Two children died Friday after being infected with a rare parasite associated with swimming in stagnant water, health officials said.

The boys, ages 9 and 7, did not know each other but were both believed to have been swimming in area ponds before contracting Naegleria, an amoeba that enters the body through the nose and can cause a deadly inflammation of the brain.

The typical presentation of PAM resembles bacterial meningitis, with fever, neck stiffness, nausea and headache. antibiotics are not helpful, and the patient's condition deteriorates. Unfortunately, the mortality rate is 95%, and death normally occurs in 4 to 6 days.

Diagnosis is difficult, but can be made under a microscope, looking at the CSF fluid. Because the diagnosis is normally delayed - due to its rarity - treatment is often not initiated on time. The antifungal amphtericin B and rifampin are normally the initial medications used. ("Two Okla. Children Die of Rare Infection", AP/Wash Post, Aug.5)