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[Primary amebic meningoencephalitis: 1st case observed in Madagascar]

M C Jaffar-Bandjee1, J L Alessandri, B Molet

  • 1Laboratoire de biologie, Centre hospitalier départemental Félix-Guyon Saint-Denis, La Réunion, France. mcjaffar@chd-fguyon.fr

Bulletin De La Societe De Pathologie Exotique (1990)
|May 27, 2005
PubMed

Insights

This case report details the first occurrence of primary amebic meningoencephalitis (PAM) in the Southern Indian Ocean, caused by Naegleria fowleri. Despite aggressive treatment, the rare and fatal infection led to the patient's death.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Parasitology

Background:

  • Primary amebic meningoencephalitis (PAM) is a rare, fulminating, and nearly always fatal infection of the brain and meninges.
  • The causative agent is the free-living amoeba Naegleria fowleri.

Observation:

  • A 7-year-old French boy living in Madagascar contracted PAM, presumed from swimming in warm freshwater.
  • Clinical signs included headache, vomiting, and fever, progressing to loss of consciousness and delirium.

Findings:

  • Cerebrospinal fluid examination revealed purulent meningitis with Naegleria fowleri trophozoites.
  • Diagnostic tests confirmed the genus Naegleria via flagellate transformation.
  • Despite treatment with amphotericin B and tetracycline, the patient developed complications including myocarditis and diabetes insipidus, ultimately succumbing to the infection.

Implications:

  • This case highlights the first documented instance of PAM in the Southern Indian Ocean region.
  • It underscores the importance of recognizing Naegleria fowleri infections, even in previously unaffected areas.
  • Early diagnosis and aggressive treatment are crucial, though the prognosis remains poor for PAM.

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