Compressive review in Diagnosis and Treatment of Primary Amoebic Meningoencephalitis

Pharmacy

Primary Amoebic Meningoencephalitis (PAM) is a rare but rapidly fatal brain infection caused by the thermophilic amoeba Naegleria fowleri. The disease primarily affects healthy individuals exposed to warm freshwater, where trophozoites enter via the nasal cavity and migrate along the olfactory nerve to the brain. Once in the central nervous system, the amoeba triggers extensive tissue destruction through proteolytic enzymes, pore-forming proteins, and immune evasion strategies. This review outlines the organism’s life cycle, environmental resilience, and genomic plasticity, including the role of extracellular vesicles (EVs) in delivering virulence factors and modulating host immunity. The host’s immune response, though rapid, often causes collateral damage through neutrophil infiltration, cytokine storms, and blood–brain barrier disruption. Diagnostic advancements such as PCR, immunofluorescence, and molecular assays have improved early detection. Treatment remains challenging, relying on early administration of amphotericin B, miltefosine, and azole antifungals, supported by intensive neurocritical care. Emerging nanomedicine-based delivery systems offer promise for targeted, less toxic therapies. Preventive strategies emphasize public education, safe water practices, and environmental monitoring.

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