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Medical Author:

Mary D. Nettleman, MD, MS, MACP

Mary D. Nettleman, MD, MS, MACP

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.

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Medical Editor:

Charles Patrick Davis, MD, PhD

Charles Patrick Davis, MD, PhD

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.

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In this Article

• Naegleria fowleri infection facts
• What is Naegleria fowleri?
• What causes a Naegleria fowleri infection?
• What are risk factors for Naegleria fowleri infection?
• What are symptoms and signs of a Naegleria fowleri infection?
• How is a Naegleria fowleri infection diagnosed?
• What is the treatment for a Naegleria fowleri infection?
• Can Naegleria fowleri infections be prevented?
• What is the prognosis of a Naegleria fowleri infection?
• Where can people find additional information about Naegleria fowleri infections?
• Naegleria Infection Index

Because Naegleria meningoencephalitis is rare, there are no studies comparing one treatment regimen to another.

The treatment of choice is amphotericin B, which is an intravenous drug usually used for fungal infections. In addition to intravenous treatment, amphotericin B can be instilled directly into the brain (intrathecally).

Other drugs such as rifampin (Rifadin), voriconazole (Vfend), or miltefosine (Miltex) have activity against Naegleria fowleri and may sometimes be used in combination with amphotericin B. However, there is no scientific data available to determine the clinical efficacy of these medications and no official recommendation for their use.

Infection with Naegleria fowleri can be prevented by avoiding aspiration of fresh water into the nose. Although there have been investigations of how to reduce the risk of disease, it is not possible to eliminate the amoeba from all freshwater sources. Standard chlorination of swimming pools is sufficient to eliminate the organism. Untreated well water should not be forced into the nose or used to irrigate the nose.

The prognosis for infected patients is very poor. More than 95% of infections are fatal despite treatment. Survivors may have residual neurological problems, such as seizure disorders.

The CDC is a good source of information on Naegleria infections: http://www.cdc.gov/parasites/Naegleria/faqs.html.

REFERENCE:

Yoder, J.S., B.A. Eddy, G.S. Visvesvara, L. Capewell, and M.J. Beach. "The Epidemiology of Primary Amoebic Meningoencephalitis in the USA, 1962-2008." Epidemiol Infect. 138.7 July 2010: 968-975.