Primary Amoebic Meningoencephalitis | 23 Jul 2024

Source: TH

Kerala has issued technical guidelines for the diagnosis, management, and prevention of Primary amoebic meningoencephalitis (PAM) following recent cases of this rare but fatal infection.

The Kerala Health Department has introduced SOPs for handling acute meningitis cases, potentially the first set of guidelines in India for this rare infection. The amoebic parasite Naegleria fowleri was identified in most cases, with Vermamoeba vermiformis implicated in one case.
Disease Characteristics: PAM is caused by Naegleria fowleri, free-living amoebae in warm, stagnant freshwater and has a high mortality rate (>97%).
- Known as the “brain-eating amoeba,” it infects the brain through the nasal passages, leading to severe brain tissue destruction.
- Children are particularly vulnerable, though PAM does not spread from person to person or through swallowing contaminated water.
Symptoms and Diagnosis: Symptoms include headache, fever, nausea, and vomiting. PAM diagnosis is challenging and often mistaken for bacterial meningitis.
- Bacterial meningitis is an infection of the meninges, which is the protective covering for the brain and spinal cord resulting in inflammation. It is a serious and life-threatening condition.
Treatment: Early diagnosis and timely initiation of an antimicrobial cocktail are crucial. The optimal drug regimen is still uncertain, and treatment involves a multidisciplinary team.
Prevention Measures: Avoid exposure to stagnant freshwater, use nose plugs, and ensure proper chlorination and maintenance of swimming pools to prevent PAM.
Vermamoeba vermiformis is a free-living amoeba found in natural and man-made environments, including freshwater sources.
- It can host various pathogens and is linked to opportunistic diseases such as encephalitis and epithelial disorders.