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Primary Amebic Menigoencephalitis (PMA)

• Nagelria fowleri is a free living thermophilic ameba inhabiting in fresh water ponds, lakes, river, hot spring, inadeqautely chlorinated swimming pools & other water supplies.

• It causes a rapidly progressive usually fatal primary amebic menigoencephalitis.

• Acanthamoeba and balamuthia causes subacute or chronic granulomatous amebic menigoencephalitis.

• It spreads through nose from infected water.

Clinical Feature

• Fever

• Headache

• Nausea, vomiting

• Change in taste (dysgeusia), smell (parosmia) may be present.

• They rapidly progress to coma death occurs within several days to 2 weeks, usually without any focal deficit.

Diagnosis

• CSF :

  • Microscopic examination of motile trophozites but may undergo rapid degenration.

  • Elevated proteins, decreased sugars, RBC's are seen.

• PCR: PCR should be done to prove if microscopy is negative.

Treatment

• Amphotericin B

Prognosis

• Mortality is 98%; only one survival has been reported till now.

Updated on 18/3/2014

Reference

• Harrison

• PMA ; Photo quiz, Clinical Infectious Disease,2012

• Facts about Naelgeria fowleri & Primary meningoencephalitis ; CDC.