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Primary amoebic meningo-encephalitis due to Naegleria fowleri

Ragini Jain1, Vijai Tilak

  • 1Institute of Medical Sciences, Banaras Hindu University, Varanasi.

Journal of the Indian Medical Association
|February 10, 2012
PubMed

Insights

Primary amoebic meningoencephalitis (PAM) is a rare, fatal brain infection caused by Naegleria fowleri. This case highlights a fatal PAM infection in an immunocompromised patient, emphasizing diagnostic challenges.

Area of Science:

  • Infectious Diseases
  • Neuroscience
  • Microbiology

Background:

  • Primary amoebic meningoencephalitis (PAM) is a devastating infection of the central nervous system.
  • It is caused by the free-living amoeba Naegleria fowleri, typically acquired through freshwater submersion.
  • Immunocompromised individuals may be at increased risk for severe outcomes.

Observation:

  • A case report of a 35-year-old male with human immunodeficiency virus and pulmonary tuberculosis is presented.
  • The patient developed symptoms consistent with meningoencephalitis after swimming in warm freshwater.
  • Rapidly progressive neurological decline was observed.

Findings:

  • Naegleria fowleri was identified in cerebrospinal fluid (CSF) via wet mount examination.
  • Diagnosis was confirmed by culturing Naegleria fowleri from CSF on non-nutrient agar with Escherichia coli.
  • Despite treatment with amphotericin B and antitubercular therapy, the patient succumbed to the infection.

Implications:

  • This case underscores the critical need to consider PAM in patients with unexplained meningoencephalitis, especially those with a history of freshwater exposure.
  • Early and accurate diagnosis is crucial, though treatment options remain limited and outcomes are often fatal.
  • Co-infection or underlying immunocompromise may influence disease presentation and progression.

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