Etiological, Pathological, Epidemiological, and Diagnostical Considerations of Primary Amoebic Meningoencephalitis

Abstract

Swimming-associated, primary amoebic meningoencephalitis, though a rare disease, has received much attention for its high fatality rate, novel mode of transmission, and its cause—an amoeba which is morphologically indistinguishable from the free-living amoeba Naegleria gruberi commonly found in soil (Sandon, 1927; Singh, 1952), water, and sewage effluent (Chang, 1971, 1972). The enigma of the disease is further deepened by the occurrence of a few non-swimming-associated cases of less fulminating and longer clinical course, and with distinctly different pathological changes (Patras and Andujar, 1966; Jager and Stamm, 1972; Rorke et al., 1971). Even more puzzling is the report of four cases of swimming-associated, fulminating meningoencephalitis caused by mycetamoeba (Mandel et al., 1970). Duma (1972) however, indicated in his personal communication with Dr. P. K. C. Austwick, that the causative agent of these cases was identified as Naegleria.