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Volume 30, Number 4—April 2024
Research Letter

Successful Treatment of Confirmed Naegleria fowleri Primary Amebic Meningoencephalitis

Ahmed Mujadid Khan Burki, Luqman SattiComments to Author , Saira Mahboob, Syed Onaiz Zulfiqar Anwar, Mahwash Bizanjo, Muhammad Rafique, and Najia Karim Ghanchi
Author affiliations: PNS Shifa Hospital, Karachi, Pakistan (A.M.K. Burki, L. Satti, S. Mahboob, S.O.Z. Anwar, M. Bizanjo, M. Rafique); Aga Khan University, Karachi (N.K. Ghanchi)

Main Article

Table

Demographic profiles, time from symptom onset to diagnosis, and management of 8 confirmed survivors of Naegleria fowleri infection, 1971–2023*

Country, year of infection (reference) Age, y/sex Time from symptom onset to diagnosis Therapy given Adjuvant therapy
Australia, 1971 (5)
 14/M
 Unknown
 Unknown
 Unknown
United States, 1978 (6)
 9/M
 3 d
 Intravenous and intrathecal amphotericin b, intravenous and intrathecal miconazole, oral rifampin, intravenous sulfisoxazole
 Intravenous dexamethasone, intravenous phenytoin
Mexico, 2003 (7)
 10/M
 9 h
 Intravenous amphotericin, intravenous fluconazole, intravenous dexamethasone, oral rifampin
 ETT, intravenous dexamethasone
United States, 2013 (8)
 12/F
 2 d
 Intravenous amphotericin, intravenous fluconazole, oral rifampin, intravenous azithromycin, oral miltefosine after 3 d, intrathecal amphotericin on second day for 10 d
 Intravenous dexamethasone, extraventricular drain, intravenous 20% mannitol with hypertonic saline, hypothermia
United States, 2013 (9)
 8/M
 5 d
 Intravenous amphotericin, oral rifampin, intravenous fluconazole, intravenous azithromycin, oral miltefosine
 ETT, EVD, dexamethasone, mannitol
Pakistan, 2015 (10)
 25/M
 3 d
 Intravenous amphotericin, oral rifampin, intravenous fluconazole
 Intravenous chlorpromazine
United States, 2016 (NA)
 16/M
 1 d
 Intravenous amphotericin, intravenous fluconazole, oral rifampin, intravenous azithromycin, oral miltefosine after 3 d, intrathecal amphotericin on second day for 10 d
 Mechanical ventilation, hypothermia
Pakistan, 2023 (this case) 22/M 2 d Intravenous amphotericin, intravenous fluconazole, oral rifampin, intravenous azithromycin, oral miltefosine, intrathecal amphotericin for 2 d Mechanical ventilation, intravenous sodium valproate, intravenous 20% mannitol

*ETT, endotracheal tube intubation; EVD, external ventricular drain; NA, not applicable (only news reports).

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References
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Page created: February 22, 2024
Page updated: March 25, 2024
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