Prompt diagnosis and extraordinary survival from Naegleria fowleri meningitis: A rare case report

Abstract

Primary amoebic meningoencephalitis is a rare fatal meningitis caused by free living amoeba Naegleria fowleri, found in freshwater ponds and lakes. It infects children and young adults with exposure due to swimming or diving. We report a case of N. fowleri meningitis in a 6-year-old boy who presented with signs and symptoms of acute bacterial meningitis. No history of travelling or swimming was present. However, the boy frequently played with water stored from a "kuhl" (diversion channels of water). Wet mount of cerebrospinal fluid (CSF) revealed amoeboid and actively motile flagellate forms of trophozoites. CSF culture done on 1.5% non-nutrient agar plates with a lawn culture of Escherichia coli kept at 37°C for 15 days did not reveal any growth. The test of flagellation on passing CSF in distilled water was however positive in 3 h. Water of the "kuhl" from the stored tank also showed actively motile trophozoites similar to the forms obtained from the CSF. Based on our reports, the boy was immediately treated with amphotericin B, rifampicin and fluconazole for 21 days. Repeat CSF examination after 14 days did not reveal any trophozoites in wet mount and patient was discharged after 3 weeks of successful treatment.

Prevalence of Naegleria fowleri in Environmental Samples from Northern Part of India

“…Nearly two third cases of PAM have been reported from the United States of America (USA) alone and rest from the other parts of the world. So far, there are only 16 reported cases of PAM in India [ 20 – 35 ]. Out of 16 cases only 4 patients survived, of which 3 had no history of exposure to recreational water bodies, which makes it again suspicious whether these cases truly were N .…”

Case Report and Literature Review: Bacterial Meningoencephalitis or Not? Naegleria fowleri Related Primary Amoebic Meningoencephalitis in China

“…To make an accurate diagnosis as soon as possible, we summarized the clinical features of this case and another 15 cases of children infected with PAM worldwide in the past 10 years (Supplementary Table S2) (13,(18)(19)(20)(21)(22)(23)(24)(25)(26). Among these 16 cases, 12 of them were reported in the United States, indicating its high incidence there.…”

Laurinterol from Laurencia johnstonii eliminates Naegleria fowleri triggering PCD by inhibition of ATPases

“…Current therapeutic options involves a combination of drugs which includes amphotericin B, azithromycin, rifampin, azoles and lately miltefosine with or without the combination of hypothermia 6 , 12 , 13 . Even though, recent cases of PAM treatment have been reported to be successful 14 – 16 , there is still an urgent need to find novel anti-amoebic agents which are able to eliminate the pathogen also causing low toxicity.…”