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Review
. 2023 Jun 1;36(3):186-191.
doi: 10.1097/QCO.0000000000000923. Epub 2023 Apr 10.

Amebic encephalitis and meningoencephalitis: an update on epidemiology, diagnostic methods, and treatment

Julia C Haston  1 , Jennifer R Cope  2
Affiliations
Review

Amebic encephalitis and meningoencephalitis: an update on epidemiology, diagnostic methods, and treatment

Julia C Haston et al. Curr Opin Infect Dis. .

Abstract

Purpose of review: Free-living amebae (FLA) including Naegleria fowleri , Balamuthia mandrillaris , and Acanthamoeba species can cause rare, yet severe infections that are nearly always fatal. This review describes recent developments in epidemiology, diagnosis, and treatment of amebic meningoencephalitis.

Recent findings: Despite similarities among the three pathogenic FLA, there are notable variations in disease presentations, routes of transmission, populations at risk, and outcomes for each. Recently, molecular diagnostic tools have been used to diagnose a greater number of FLA infections. Treatment regimens for FLA have historically relied on survivor reports; more data is needed about novel treatments, including nitroxoline.

Summary: Research to identify new drugs and guide treatment regimens for amebic meningoencephalitis is lacking. However, improved diagnostic capabilities may lead to earlier diagnoses, allowing earlier treatment initiation and improved outcomes. Public health practitioners should continue to prioritize increasing awareness and providing education to clinicians, laboratorians, and the public about amebic infections.

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Conflict of interest statement

Conflicts of interest

There are no conflicts of interest.

References

    1. Centers for Disease Control and Prevention. Free living amebic infections 2019. Available at: https://www.cdc.gov/dpdx/freelivingamebic/index.html. [Accessed 12 January 2023]
    1. Centers for Disease Control and Prevention. Naegleria fowleri - primary amebic meningoencephalitis (PAM) - sources of infection & risk factors 2023. Available at: https://www.cdc.gov/parasites/naegleria/infection-sources.html. [Accessed 10 February 2023]
    1. Cope JR, Landa J, Nethercut H, et al. The epidemiology and clinical features of Balamuthia mandrillaris disease in the United States, 1974–2016. Clin Infect Dis 2019; 68:1815–1822. - PMC - PubMed
    1. Haston JC, O’Laughlin K, Matteson K, et al. The epidemiology and clinical features of non-keratitis Acanthamoeba infections in the United States, 1956–2020. Open Forum Infect Dis 2023; 10:ofac682. - PMC - PubMed

    2. A review of all invasive Acanthamoeba cases in the United States, describing epidemiologic trends and clinical features.

    1. Centers for Disease Control and Prevention. Naegleria fowleri - primary amebic meningoencephalitis (PAM) - Treatment 2022. Available at: https://www.cdc.gov/parasites/naegleria/treatment-hcp.html.

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