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Primary meningoencephalitis by Naegleria fowleri: first reported case from Mangalore, South India

Shalini Shenoy1, Godwin Wilson, H V Prashanth

  • 1Department of Microbiology, Kasturba Medical College, Mangalore, Karnataka, 575001, India. tvshenoy@hotmail.com

Insights

A fatal case of primary amebic meningoencephalitis (PAM) in an infant highlights the risk of infection from artificial wells. Naegleria fowleri, identified in the cerebrospinal fluid and well water, caused the fatal outcome.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Environmental Health

Background:

  • Primary amebic meningoencephalitis (PAM) is a rare and typically fatal infection of the central nervous system.
  • Naegleria fowleri is a free-living ameba commonly found in warm freshwater environments.

Observation:

  • A 5-month-old infant presented with symptoms consistent with PAM.
  • The infant had a history of bathing in water from an artificial well.
  • Ameba, identified as Naegleria fowleri, was isolated from the infant's cerebrospinal fluid.

Findings:

  • The isolated ameba demonstrated growth above 30 degrees C, characteristic trophozoite morphology, and flagellate forms, confirming it as Naegleria fowleri.
  • Pathogenic Naegleria fowleri amebae were successfully recovered from the artificial well water samples.
  • The infant's condition showed a poor response to amphotericin B treatment, leading to a fatal outcome.

Implications:

  • This case underscores the potential for Naegleria fowleri infection through non-swimming water-related activities, such as bathing.
  • Artificial wells can serve as a source of pathogenic Naegleria fowleri, posing a risk to public health.
  • The findings emphasize the need for increased awareness and preventative measures against PAM, especially in vulnerable populations like infants.

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