Naegleria fowleri Infections: Bridging Clinical Observations and Epidemiological Insights

Naegleria fowleri is the main etiologic agent implicated in primary amoebic meningoencephalitis (PAM). It is also known as the brain-eating amoeba because of the severe brain inflammation following infection, with a survival rate of about 5%. This review aims to identify Naegleria fowleri infections and evaluate patients' progression. This literature review emphasizes the importance of rapid diagnosis and treatment of infected patients because only prompt initiation of appropriate therapy can lead to medical success. Compared to other articles of this kind, this one analyzes a large number of reported cases and all the factors that affected patients' evolution.

Two independent reviewers used "Naegleria fowleri" and "case report" as keywords in the Clarivate Analytics-Web of Science literature review, obtaining 163 results. The first evaluation step was article title analysis. The two reviewers determined if the title was relevant to the topic. The first stage removed 34 articles, leaving 129 for the second stage. Full-text articles were evaluated after reading the abstract, and 77 were eliminated. This literature review concluded with 52 articles.

This review included 52 case report articles, 17 from the USA, eight from India, seven from China, four from Pakistan, two from the UK, and one each from Thailand, Korea, Japan, Italy, Iran, Norway, Turkey, Costa Rica, Zambia, Australia, Taiwan, and Venezuela, and Mexico. This study included 98 patients, with 17 women (17.4%) and 81 men (82.6%). The cases presented in this study show that waiting to start treatment until a diagnosis is confirmed can lead to rapid worsening and bad outcomes, especially since there is currently no drug that works very well as a treatment and the death rate is around 98%.

The lack of case presentation standardization may lead to incomplete case information in the review since the cases did not follow a writing protocol. The small number of global cases may also lead to misleading generalizations, especially about these patients' treatment. Due to the small number of cases, there is no uniform sample of patients, making it difficult to determine the exact cause of infection.