The Deadly Amoeba: A Rare Case Report of Primary Amoebic Meningoencephalitis by Naegleria Fowleri

Introduction Naegleria fowleri (N.fowleri), a thermophilic, free-living amoeba found in warm freshwater, causes primary amoebic meningoencephalitis (PAM), a rare, highly fatal brain infection with over 97% mortality. PAM mimics bacterial meningitis, presenting vague symptoms like fever and headache, progressing to severe neurological signs. Case report Post mortem viscera of a 46 year old male was received with the alleged history of altered sensorium. The gross examination of  brain showed opaque, granular leptomeninges with multiple necrotic grey brown areas of 1.5–2.5 cm were noted in the frontal, parietal and temporal lobes and both cerebellum. Microscopy revealed neutrophilic exudate, necrosis, hemorrhage, dense inflammatory infiltrates and round to oval PAS positive, amoebic trophozoites, consistent with N. Conclusion This case marks only the second reported case of N. fowleri meningoencephalitis in Haryana. Increased awareness, public education and water monitoring are crucial for prevention. Early detection through improved diagnostic protocols can significantly reduce the associated high mortality rates.