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Primary amoebic meningoencephalitis in an Iranian infant

Zahra Movahedi1, Mohammad Reza Shokrollahi, Mohammad Aghaali

  • 1Qom University of Medical Science, Qom, Iran.

Case Reports in Medicine
|August 18, 2012
PubMed

Insights

This report details the first case of primary amoebic meningoencephalitis (PAM) in Iran, caused by Naegleria fowleri. Early diagnosis and treatment led to a full recovery in a pediatric patient.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Parasitology

Background:

  • Naegleria fowleri is a free-living amoeba responsible for severe, often fatal, human infections.
  • Primary amoebic meningoencephalitis (PAM) is a rare but devastating central nervous system infection.
  • This case represents the first documented occurrence of PAM in Iran.

Purpose of the Study:

  • To report the first case of primary amoebic meningoencephalitis (PAM) in Iran.
  • To highlight the diagnostic challenges and successful treatment of Naegleria fowleri infection in an infant.
  • To emphasize the importance of considering PAM in the differential diagnosis of pediatric meningitis.

Main Methods:

  • A five-month-old infant presented with symptoms suggestive of meningitis.
  • Cerebrospinal fluid (CSF) analysis revealed the presence of Naegleria fowleri via microscopic examination.
  • Treatment was initiated with Amphotericin B and Rifampin.

Main Results:

  • The infant diagnosed with Naegleria fowleri infection showed signs of communicated hydrocephalus on CT scans.
  • Microscopic examination of CSF confirmed the presence of Naegleria fowleri.
  • Following treatment with Amphotericin B and Rifampin, the patient experienced a complete recovery two months later.

Conclusions:

  • Primary amoebic meningoencephalitis, though rare, carries a grave prognosis.
  • Naegleria fowleri infections should be considered in pediatric patients with purulent meningitis, especially when bacterial causes are not evident on Gram stain or imaging.
  • Early detection and prompt treatment are crucial for improving outcomes in PAM cases.

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