Distinguishing the features of amoebic nuclei from those
of monocytes is particularly important in diagnosing
PAM, as the two cell types can be confused. Monocyte
nuclei are significantly larger with higher nuclear to
cytoplasmic ratios than those of amoebae. Furthermore,
monocyte nuclei do not appear clear but rather have a
uniform and slightly ropey chromatin pattern without
distinct nucleoli
(94)
. After cytocentrifugation staining
specimens with Giemsa or Trichrome stains can enhance
N. fowleri trophozoite features
(95)
.