| Summary: | Introduction: Primary amoebic meningoencephalitis (PAM) is a rare but lethal infection
of the brain caused by a eukaryote called Naegleria fowleri (N. fowleri). The aim of this review is to
consolidate the recently published case reports of N. fowleri infection by describing its epidemiology
and clinical features with the goal of ultimately disseminating this information to healthcare personnel.
Methods: A comprehensive literature search was carried out using PubMed, Web of Science, Scopus,
and OVID databases until 31 December 2022 by two independent reviewers. All studies from the year
2013 were extracted, and quality assessments were carried out meticulously prior to their inclusion
in the final analysis. Results: A total of 21 studies were selected for qualitative analyses out of the
461 studies extracted. The cases were distributed globally, and 72.7% of the cases succumbed to
mortality. The youngest case was an 11-day-old boy, while the eldest was a 75-year-old. Significant
exposure to freshwater either from recreational activities or from a habit of irrigating the nostrils
preceded onset. The symptoms at early presentation included fever, headache, and vomiting, while
late sequalae showed neurological manifestation. An accurate diagnosis remains a challenge, as
the symptoms mimic bacterial meningitis. Confirmatory tests include the direct visualisation of the
amoeba or the use of the polymerase chain reaction method. Conclusions: N. fowleri infection is
rare but leads to PAM. Its occurrence is worldwide with a significant risk of fatality. The suggested
probable case definition based on the findings is the acute onset of fever, headache, and vomiting
with meningeal symptoms following exposure to freshwater within the previous 14 days. Continuous
health promotion and health education activities for the public can help to improve knowledge and
awareness prior to engagement in freshwater activities.
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