We present the first recognized case of primary amebic meningoencephalitis (PAM) caused by Naegleria fowleri in a 15-year-old male from Bangladesh. He performed daily nasal rinsing with untreated ground water and bathed in untreated ground water or river water, which likely exposed him to N. fowleri.
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Tax calculation will be finalised during checkout.
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
Tax calculation will be finalised during checkout.
Blair B, Sarkar P, Bright KR, Marciano-Cabral F, Gerba CP (2008) Naegleria fowleri in well water. Emerg Infect Dis 14(9):1499–1501. https://doi.org/10.3201/eid1409.071076
Capewell LG, Harris AM, Yoder JS, Cope JR, Eddy BA, Roy SL, Visvesvara GS, Fox LM, Beach MJ (2015) Diagnosis, clinical course, and treatment of primary amoebic meningoencephalitis in the United States, 1937-2013. J Pediatric Infect Dis Soc 4(4):e68–e75. https://doi.org/10.1093/jpids/piu103
Centers for Disease Control and Prevention (2013) Notes from the field: primary amebic meningoencephalitis associated with ritual nasal rinsing--St. Thomas, US Virgin islands, 2012. MMWR Morbidity and mortality weekly report 62(45):903
Cope JR, Ratard RC, Hill VR, Sokol T, Causey JJ, Yoder JS, Mirani G, Mull B, Mukerjee KA, Narayanan J, Doucet M, Qvarnstrom Y, Poole CN, Akingbola OA, Ritter JM, Xiong Z, da Silva AJ, Roellig D, van Dyke R, Stern H, Xiao L, Beach MJ (2015) The first association of a primary amebic meningoencephalitis death with culturable Naegleria fowleri in tap water from a US treated public drinking water system. Clin Infect Dis 60(8):e36–e42. https://doi.org/10.1093/cid/civ017
Coupat-Goutaland B, Régoudis E, Besseyrias M, Mularoni A, Binet M, Herbelin P, Pélandakis M (2016) Population structure in Naegleria fowleri as revealed by microsatellite markers. PLoS One 11(4):e0152434
De Jonckheere JF (2011) Origin and evolution of the worldwide distributed pathogenic amoeboflagellate Naegleria fowleri. Infect Genet Evol 11(7):1520–1528
Gautam PL, Sharma S, Puri S, Kumar R, Midha V, Bansal R (2012) A rare case of survival from primary amebic meningoencephalitis. Indian J Crit Care Med 16(1):34–36. https://doi.org/10.4103/0972-5229.94432
Ghanchi NK, Jamil B, Khan E, Ansar Z, Samreen A, Zafar A, Hasan Z (2017) Case series of Naegleria fowleri primary ameobic meningoencephalitis from Karachi, Pakistan. Am J Trop Med Hyg 97(5):1600–1602. https://doi.org/10.4269/ajtmh.17-0110
Gupta N, Bhaskar H, Duggal S, Ghalaut PS, Kundra S, Arora DR (2009) Primary amoebic meningoencephalitis: first reported case from Rohtak, North India. Braz J Infect Dis 13(3):236–237
Gupta R, Parashar MK, Kale A (2015) Primary amoebic meningoencephalitis. J Assoc Physicians India 63(4):69–71
Khanna V et al (2011) Primary amoebic meningoencephalitis in an infant due to Naegleria fowleri. Case Rep Neurol Med 2011
Linam WM et al (2015) Successful treatment of an adolescent with Naegleria fowleri primary amebic meningoencephalitis. Pediatrics 135(3):e744
Pélandakis M, Serre S, Pernin P (2000) Analysis of the 5.8 S rRNA gene and the internal transcribed spacers in Naegleria spp. and in N. fowleri. J Eukaryot Microbiol 47(2):116–121
Qvarnstrom Y, Visvesvara GS, Sriram R, da Silva AJ (2006) Multiplex real-time PCR assay for simultaneous detection of Acanthamoeba spp., Balamuthia mandrillaris, and Naegleria fowleri. J Clin Microbiol 44(10):3589–3595. https://doi.org/10.1128/JCM.00875-06
Saleem T, Rabbani M, Jamil B (2009) Primary amoebic meningoencephalitis: two new cases from Pakistan. Trop Dr 39(4):242–243. https://doi.org/10.1258/td.2009.090032
Sazzad HM, Luby SP, Ströher U, Daszak P, Sultana S, Afroj S, Rahman M, Gurley ES (2015) Exposure-based screening for Nipah virus encephalitis, Bangladesh. Emerg Infect Dis 21(2):349–351. https://doi.org/10.3201/eid2102.141129
Seidel JS, Harmatz P, Visvesvara GS, Cohen A, Edwards J, Turner J (1982) Successful treatment of primary amebic meningoencephalitis. N Engl J Med 306(6):346–348. https://doi.org/10.1056/nejm198202113060607
Shakoor S, Beg MA, Mahmood SF, Bandea R, Sriram R, Noman F, Ali F, Visvesvara GS, Zafar A (2011) Primary amebic meningoencephalitis caused by Naegleria fowleri, Karachi, Pakistan. Emerg Infect Dis 17(2):258–261. https://doi.org/10.3201/eid1702.100442
Siddiqui R, Ali IKM, Cope JR, Khan NA (2016) Biology and pathogenesis of Naegleria fowleri. Acta Trop 164:375–394. https://doi.org/10.1016/j.actatropica.2016.09.009
Sood A, Chauhan S, Chandel L, Jaryal SC (2014) Prompt diagnosis and extraordinary survival from Naegleria fowleri meningitis: a rare case report. Indian J Med Microbiol 32(2):193–196. https://doi.org/10.4103/0255-0857.129834
Stubhaug TT et al (2016) Fatal primary amoebic meningoencephalitis in a Norwegian tourist returning from Thailand. JMM Case Rep 3(3)
Tiewcharoen S, Junnu V, Sassa-Deepaeng T, Waiyawuth W, Ongrothchanakul J, Wankhom S (2007) Analysis of the 5.8 S rRNA and internal transcribed spacers regions of the variant Naegleria fowleri Thai strain. Parasitol Res 101(1):139–143
Tung M-C, Hsu BM, Tao CW, Lin WC, Tsai HF, Ji DD, Shen SM, Chen JS, Shih FC, Huang YL (2013) Identification and significance of Naegleria fowleri isolated from the hot spring which related to the first primary amebic meningoencephalitis (PAM) patient in Taiwan. Int J Parasitol 43(9):691–696
Yadav D, Aneja S, Dutta R, Maheshwari A, Seth A (2013) Youngest survivor of Naegleria meningitis. Indian J Pediatr 80(3):253–254. https://doi.org/10.1007/s12098-012-0756-2
Yoder JS, Eddy BA, Visvesvara GS, Capewell L, Beach MJ (2010) The epidemiology of primary amoebic meningoencephalitis in the USA, 1962-2008. Epidemiol Infect 138(7):968–975. https://doi.org/10.1017/S0950268809991014
Yoder JS, Straif-Bourgeois S, Roy SL, Moore TA, Visvesvara GS, Ratard RC, Hill VR, Wilson JD, Linscott AJ, Crager R, Kozak NA, Sriram R, Narayanan J, Mull B, Kahler AM, Schneeberger C, da Silva AJ, Poudel M, Baumgarten KL, Xiao L, Beach MJ (2012) Primary amebic meningoencephalitis deaths associated with sinus irrigation using contaminated tap water. Clin Infect Dis 55(9):e79–e85. https://doi.org/10.1093/cid/cis626
Zhang LL, Wu M, Hu BC, Chen HL, Pan JR, Ruan W, Yao LN (2018) Identification and molecular typing of Naegleria fowleri from a patient with primary amebic meningoencephalitis in China. Int J Infect Dis 72:28–33. https://doi.org/10.1016/j.ijid.2018.05.001
Zhou L, Sriram R, Visvesvara GS, Xiao L (2003) Genetic variations in the internal transcribed spacer and mitochondrial small subunit rRNA gene of Naegleria spp. J Eukaryot Microbiol 50(Suppl):522–526
icddr,b acknowledges with gratitude the commitment of Centers for Disease Control and Prevention (CDC), NIH, and Government of Bangladesh for their research efforts. icddr,b is thankful to the Governments of Australia, Bangladesh, Canada, Sweden, and the UK for providing core/unrestricted support.
The study was funded by the US National Institutes of Health (NIH), grant number 07-015-0712-52200 (Bangladesh-NIH/EID), and NSF/NIH Ecology and Evolution of Infectious Diseases grant number 2R01-TW005869 from the Fogarty International Center.
The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the U.S. Centers for Disease Control and Prevention.
Conflict of interest
The authors declare that they have no conflict of interest.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Handling Editor: Julia Walochnik
Electronic supplementary material
About this article
Cite this article
Sazzad, H.M.S., Luby, S.P., Sejvar, J. et al. A case of primary amebic meningoencephalitis caused by Naegleria fowleri in Bangladesh. Parasitol Res 119, 339–344 (2020). https://doi.org/10.1007/s00436-019-06463-y
- Naegleria fowleri
- Primary amebic meningoencephalitis
- Ritual rinsing
- Free-living ameba