Systematic review of brain-eating amoeba: a decade update

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...

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Main Authors: Ahmad Zamzuri, Mohd ‘Ammar Ihsan, Abd Majid, Farah Nabila, Mihat, Massitah, Ibrahim, Siti Salwa, Ismail, Muhammad, Abd Aziz, Suriyati, Mohamed, Zuraida, Rejali, Lokman, Yahaya, Hazlina, Abdullah, Zulhizzam, Hassan, Mohd Rohaizat, Dapari, Rahmat, Mohd Isa, Abd Majid
Format: Article
Published: MDPI 2023
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author Ahmad Zamzuri, Mohd ‘Ammar Ihsan
Abd Majid, Farah Nabila
Mihat, Massitah
Ibrahim, Siti Salwa
Ismail, Muhammad
Abd Aziz, Suriyati
Mohamed, Zuraida
Rejali, Lokman
Yahaya, Hazlina
Abdullah, Zulhizzam
Hassan, Mohd Rohaizat
Dapari, Rahmat
Mohd Isa, Abd Majid
author_facet Ahmad Zamzuri, Mohd ‘Ammar Ihsan
Abd Majid, Farah Nabila
Mihat, Massitah
Ibrahim, Siti Salwa
Ismail, Muhammad
Abd Aziz, Suriyati
Mohamed, Zuraida
Rejali, Lokman
Yahaya, Hazlina
Abdullah, Zulhizzam
Hassan, Mohd Rohaizat
Dapari, Rahmat
Mohd Isa, Abd Majid
author_sort Ahmad Zamzuri, Mohd ‘Ammar Ihsan
collection UPM
description 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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spelling upm.eprints-1090422024-10-14T03:46:57Z http://psasir.upm.edu.my/id/eprint/109042/ Systematic review of brain-eating amoeba: a decade update Ahmad Zamzuri, Mohd ‘Ammar Ihsan Abd Majid, Farah Nabila Mihat, Massitah Ibrahim, Siti Salwa Ismail, Muhammad Abd Aziz, Suriyati Mohamed, Zuraida Rejali, Lokman Yahaya, Hazlina Abdullah, Zulhizzam Hassan, Mohd Rohaizat Dapari, Rahmat Mohd Isa, Abd Majid 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. MDPI 2023-02-09 Article PeerReviewed Ahmad Zamzuri, Mohd ‘Ammar Ihsan and Abd Majid, Farah Nabila and Mihat, Massitah and Ibrahim, Siti Salwa and Ismail, Muhammad and Abd Aziz, Suriyati and Mohamed, Zuraida and Rejali, Lokman and Yahaya, Hazlina and Abdullah, Zulhizzam and Hassan, Mohd Rohaizat and Dapari, Rahmat and Mohd Isa, Abd Majid (2023) Systematic review of brain-eating amoeba: a decade update. International Journal of Environmental Research and Public Health, 20 (4). art. no. 3021. pp. 1-12. ISSN 1661-7827; ESSN: 1660-4601 https://www.mdpi.com/1660-4601/20/4/3021 10.3390/ijerph20043021
spellingShingle Ahmad Zamzuri, Mohd ‘Ammar Ihsan
Abd Majid, Farah Nabila
Mihat, Massitah
Ibrahim, Siti Salwa
Ismail, Muhammad
Abd Aziz, Suriyati
Mohamed, Zuraida
Rejali, Lokman
Yahaya, Hazlina
Abdullah, Zulhizzam
Hassan, Mohd Rohaizat
Dapari, Rahmat
Mohd Isa, Abd Majid
Systematic review of brain-eating amoeba: a decade update
title Systematic review of brain-eating amoeba: a decade update
title_full Systematic review of brain-eating amoeba: a decade update
title_fullStr Systematic review of brain-eating amoeba: a decade update
title_full_unstemmed Systematic review of brain-eating amoeba: a decade update
title_short Systematic review of brain-eating amoeba: a decade update
title_sort systematic review of brain eating amoeba a decade update
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