Amoebic meningitis
| Naegleriasis | |
|---|---|
| Synonyms | Primary amoebic meningoencephalitis (PAM), amebic encephalitis, naegleria infection, amoebic meningitis |
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| Histopathology of primary amebic meningoencephalitis due to Naegleria fowleri. Direct fluorescent antibody stain. | |
| Pronunciation | |
| Specialty | Infectious disease |
| Symptoms | Fever, vomiting, stiff neck, seizures, poor coordination, confusion |
| Causes | Naegleria fowleri |
| Similar conditions | Meningitis |
| Prevention | Noseclips, proper chlorination of swimming pools |
| Treatment | Amphotericin B, rifampicin, miltefosine, targeted temperature management to manage brain swelling caused by infection |
| Prognosis | Usually results in death |
| Classification |
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Naegleriasis (also known as primary amoebic meningoencephalitis) is an infection of the brain by the free-living unicellular Naegleria fowleri.
N. fowleri is typically found in warm bodies of fresh water, such as ponds, lakes, rivers, and hot springs. It is also found in soil, poorly maintained municipal water supplies, water heaters, near warm-water discharges of industrial plants, and in poorly chlorinated or unchlorinated swimming pools, in an amoeboid or temporary flagellate stage. There is no evidence of it living in salt water.
Although infection occurs rarely, it nearly always results in death, with a case fatality rate greater than 95%.
Because primary amoebic meningoencephalitis is a rare disease, it does not generate a high index of suspicion among health-care providers. Symptoms of N. fowleri infection are clinically similar to those for bacterial or viral meningitis, further lowering the index of suspicion for PAM and initiation of appropriate diagnostic testing. Improving case detection through increased awareness, reporting, and information about cases might enable earlier detection of infections, provide insight into the human or environmental determinants of infection, and allow improved assessment of treatment effectiveness.
Onset of symptoms one to nine days following exposure (with an average of five). Initial symptoms include changes in taste and smell, headache, fever, nausea, vomiting, back pain, and a stiff neck. Secondary symptoms are meningitis-like including confusion, hallucinations, lack of attention, ataxia, cramp and seizures. After the start of symptoms, the disease progresses rapidly over three to seven days, with death occurring usually from seven to fourteen days later, although it can take longer. In 2013, a man in Taiwan died twenty-five days after being infected by Naegleria fowleri.
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