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Primary Amebic Meningoencephalitis

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Primary Amebic Meningoencephalitis, Primary Amebic Encephalitis, Naegleria fowleri Encephalitis

  • See Also
  1. Waterborne Illness
  • Epidemiology
  1. Rare, but lethal Encephalitis (4 cases per year in U.S.)
  • Pathophysiology
  1. Typically occurs with swimming in fresh water lakes, rivers or hot springs
  2. Transmitted via the nasal cavity and secondary Sinusitis
  • Management
  1. Amphoteracin B 1.5 mg/kg/day (IV and consider intrathecal) AND
  2. Rifampin 10 mg/kg/day AND
  3. Fluconazole 10 mg/kg/day IV or orally AND
  4. Azithromycin 500 mg IV or orally AND
  5. Miltefosine (Impavido) 50 mg orally three times daily
    1. As of 2017, investigational, and only available from CDC (consult early and urgently if suspected case)
  • Differential Diagnosis
  1. See Encephalitis
  2. See Meningitis
  3. Other amebic meningoencephalitis (present as Chronic Granulomatous Meningitis)
    1. Balamuthia mandrillaris
    2. Acanthameba
  • Prognosis
  1. Mortality: 90%
  • References
  1. (2017) Sanford guide, accessed 5/4/2017
  2. Perkins (2017) Am Fam Physician 95(9): 554-60 [PubMed]