Naegleria fowleri: Insights and Emerging Strain in Pakistan

Naegleria fowleri (N. fowleri), commonly known as the brain-eating amoeba causes primary amebic meningoencephalitis (PAM). This rare and fatal microorganism is found in freshwater, it enters the human body through the nasal passage migrating into the brain, which causes severe inflammation and destruction of brain tissue. Over the past 50 years, 300 cases have been reported globally, with Pakistan reporting a notably higher number of cases, mainly attributed to humidity. Notably distinct age group susceptibility and infectivity patterns have been observed in Pakistan, particularly in Karachi, where ground saline water is consumed as the main source suggesting the emergence of a new adaptable strain. PAM presents symptoms like bacterial meningitis, complicating diagnosis. Official diagnosis is made with cerebrospinal fluid (CSF) analysis which shows polymorphonuclear leukocytes and trophozoites from N. fowleri. Treatment combines drug therapy and supportive care. Genotyping, raising awareness, clinical trials, and better water sanitation are vital to mitigate N. fowleri's impact. This review highlights genetic diversity, improved diagnostics, and effective treatments.