Mary D. Nettleman, MD, MS, MACP is the Chair of the Department of Medicine at Michigan State University. She is a graduate of Vanderbilt Medical School, and completed her residency in Internal Medicine and a fellowship in Infectious Diseases at Indiana University.
Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
Naegleria fowleri is an amoeba that lives
predominately in warm freshwater.
Naegleria fowleri is acquired by people
when infected water is forcibly aspirated into the nose. This can occur through
recreational swimming, diving, or during sports like water skiing.
acquired, the amoeba travels into the brain, causing primary amoebic
meningoencephalitis (PAM). In the popular press, Naegleria fowleri is sometimes called the "brain-eating amoeba," and meningoencephalitis is sometimes referred to as Naegleriasis.
PAM is very rare, and there are only a few cases
reported each year in the United States.
People with PAM have a rapidly progressive illness with fever, headache, and stiff neck, and finally coma and death.
Infection is diagnosed by examining spinal fluid under the microscope to identify the amoeba. Naegleria fowleri may also be grown in the laboratory, although this takes several days. Newer tests based on PCR technology have been developed but are not widely available.
The treatment of choice is an intravenous drug
called amphotericin B. Amphotericin B may also be instilled directly into the
brain. Because treatment with amphotericin B alone usually fails, other drugs are often added. Miltefosine is a drug that has shown promise, and it is available through the Centers for Disease Control and Prevention. Treatment should be initiated as rapidly as possible, and immediate consultation with an infectious-diseases expert is highly recommended.
More than 99% of cases of PAM are fatal despite treatment.