Primary Amoebic Meningoencephalitis (PAM)

Why in News:

Recently, Kerala’s health department has sounded an alert in Kozhikode district after three back to back cases of the rare primary amoebic meningoencephalitis (PAM) were reported in the region.

Description:

• Definition: A rare but highly fatal infection of the brain and meninges.
• Causative Agent:
  • Naegleria fowleri (popularly called the “brain-eating amoeba”).
  • Free-living amoeba found in warm freshwater and soil.

Types of Amoebic Encephalitis

1. Primary Amoebic Meningoencephalitis (PAM)
   1. Caused by Naegleria fowleri.
   1. Rapid progression → often fatal within days.
2. Granulomatous Amoebic Encephalitis (GAE)
   1. Caused by Acanthamoeba spp. and Balamuthia mandrillaris.
   1. Develops more slowly, but still deadly.

Transmission

• Occurs in shallow surface waters, warm freshwater bodies, and poorly maintained swimming pools, hot tubs, spas.
• Entry through nose while:
  • Swimming
  • Diving
  • Jumping into infected water
• Amoeba invades olfactory nerves → brain → meninges.

Affected Population

• Mostly young, active people.
• Higher risk in warm climates.

Symptoms

• Early: sore throat, headache, frontal pain
• Later: hallucinations, nausea, vomiting, fever
• Rapid deterioration → coma & death

Mortality: Extremely high (>95%).

Treatment

• Early diagnosis + aggressive therapy may help.
• Drugs tried: Amphotericin B, Miltefosine, Azithromycin.
• Recovery is rare.

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