Các biện pháp kiểm soát: Mọi người nên tránh bơi trong ấm áp, tù đọng, nước ngọt bị ô nhiễm. Acanthamoeba sinh vật có khả năng chống đóng băng, làm khô, và các nồng độ thông thường của clo được tìm thấy trong uống nước và hồ bơi. Chỉ có giải pháp dung dịch muối vô trùng nên được sử dụng để làm sạch kính áp tròng. | Control Measures People should avoid swimming in warm stagnant polluted fresh water. Acanthamoeba organisms are resistant to freezing drying and the usual concentrations of chlorine found in drinking water and swimming pools. Only sterile saline solutions should be used to clean contact lenses. Anthrax Clinical Manifestations Depending on the route of infection anthrax disease can occur in 3 forms cutaneous inhalational and gastrointestinal. Cutaneous anthrax begins as a pruritic papule or vesicle that enlarges and ulcerates in 1 to 2 days with subsequent formation of a central black eschar. The lesion characteristically is painless with surrounding edema hyperemia and regional lymphadenopathy. Patients may have associated fever malaise and headache. Inhalational anthrax is the most lethal form of disease. A prodrome of fever sweats nonproductive cough chest pain headache myalgias malaise and nausea and vomiting may occur initially but more distinctive clinical symptoms occur 2 to 5 days later in some cases following a period of improvement. These manifestations include dyspnea hypoxia and fulminant shock occurring as a result of hemorrhagic mediastinal lymphadenitis hemorrhagic pleural effusions bacteremia and toxemia. A widened mediastinum is the classic finding on imaging of the chest pleural effusions and hemorrhagic infiltrates can be present but initially changes on chest radiography may be subtle. Gastrointestinal tract disease can present as 2 clinical syndromes intestinal and oropharyngeal. Patients with the intestinal form have symptoms of nausea anorexia vomiting and fever progressing to severe abdominal pain massive ascites hematemesis and bloody diarrhea. Oropharyngeal anthrax may include posterior oropharyngeal ulcers that typically are unilateral and associated with marked neck swelling regional adenopathy and sepsis. Hemorrhagic meningitis can result from hematogenous spread of the organism after acquiring any form of disease. The case-fatality rate
