Abstract

AMOEBIC MENINGOENCEPHALITIS: A COMPREHENSIVE REVIEW OF PATHOGENESIS, DIAGNOSIS & MANAGEMENT

Arun G. Krishnan*, Amala Alex, Navya Elsa Thomas, Princy P.

Abstract

Amoebic meningoencephalitis is a rare but highly fatal infection of the central nervous system caused by free-living amoeba Naegleria fowleri. This pathogenic organism is commonly found in warm fresh water, soil and poorly chlorinated water sources. Infection typically occurs when contaminated water enters the nasal passages allowing the amoeba to migrate along the olfactory nerves into the brain. The disease progresses rapidly, resulting in extensive brain inflammation, necrosis and hemorrhage. Clinical manifestation include fever, headache, vomiting, altered mental status and seizures, often resembling bacterial meningitis, leading to frequent misdiagnosis. Diagnosis is challenging and usually confirmed through cerebrospinal fluid examination, imaging techniques or molecular assays like polymerase chain reaction (PCR). Despite aggressive therapy with amphotericin B, miltefosine, azole antifungals, mortality rates remain exceedingly high due to delayed recognition and limited treatment efficacy. Preventive measures focus on avoiding exposures to contaminated water and maintaining proper chlorination in recreational facilities. This review summarizes the epidemiology, pathogenesis, clinical features, diagnostic advancements and therapeutic strategies of amoebic meningoencephalitis, highlighting the urgent need for early diagnosis and effective treatment to improve survival outcomes.

Keywords: Amoebic meningoencephalitis, Naegleria fowleri, Central nervous system infection, diagnosis, treatment.