Abstract

A REVIEW ON PRIMARY AMOEBIC MENINGOENCEPHALITIS

Shoba S.* and Nishvanth F.

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Abstract

Primary amoebic meningoencephalitis, also known as naegleriasis, is a rare and usually fatal acute CNS infection caused by the free-living amoeba Naegleria fowleri. This is a distinct clinical syndrome to granulomatous amoebic encephalitis, which is a subacute-chronic illness in immunocompromised patients with a highly variable presentation that is caused by Acanthamoeba spp. (main cause), Balamuthia mandrillaris and Sappinia pedata. Primary amoebic meningoencephalitis fatality usually occurring within a week of symptom onset regardless of treatment status. It presents similarly to a severe and highly aggressive bacterial meningoencephalitis, with common clinical features including severe headache, high fever, nuchal rigidity, nausea, vomiting, photophobia, cranial nerve palsies, change in mental status, seizures, clinical signs of meningeal irritation and coma. A large number of cases in developing countries go unnoticed. In particular, religious, recreational, and cultural practices such as ritual ablution and/or purifications, Ayurveda, and the use of neti pots for nasal irrigation can contribute to this devastating infection. With increasing water scarcity and public reliance on water storage, here we debate the need for increased awareness of primary amoebic meningoencephalitis and the associated risk factors, particularly in developing countries.

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