An Overview of Primary Amebic Meningoencephalitis (PAM)





Primary Amoebic Meningoencephalitis (PAM) is also called Amoebic meningitis or Naegleriasis. PAM is some variety of meningitis which causes infection in the body through a type of bacteria called Amoebae. Amoebae are described as free-living organisms which are found usually in fresh water like lakes and rivers.


Generally, the term ‘free-living’ means, parasites won’t need any host to survive. It can survive (not any plant or an animal) with the help of water on its own.

Usually, amoeba will survive in water temperatures 30°C and 45°C. If you are exposed to this environment, you can get the chance to get affected.


People who want to swim, the recommended temperature for humans to swim in water is typically between 20°C to 30°C. Usually this temperature won’t allow the amoebae to survive but some amoebae will survive in fresh waters of approximately 30°C and it does have some risk. Because of this only, chlorine is present in the swimming pools which helps to keep the water clean and it kills the harmful bacterias.


Generally, amoebae can be found in some common places like ponds, lakes, rivers, hot springs, streams and unchlorinated swimming pools. We mostly contract the diseases in these places because this is the only place we would be in physical contact with water.


Some Symptoms of primary amoebic meningoencephalitis(PAM)


PAM symptoms have the same symptoms as those for meningitis.


The primary symptoms are:

  • headache

  • high fever

  • nausea (feeling sick)

  • vomiting


Usually, these symptoms will start about after the 5 days of infection.


Future symptoms are:

  • neck stiffness

  • confusion

  • loss of balance

  • seizures (fits)

  • hallucinations


With the help of early treatment and diagnosis helping you to survive. But the General fact is people who are affected with PAM usually Die.


Main Causes of primary amoebic meningoencephalitis (PAM)


Generally, the amoeba called Naegleria fowleri usually causes PAM (primary amoebic meningoencephalitis). Typically, this Naegleria fowleri amoeba grows in contaminated water. Usually this amoeba grows best in warm water of temperature between  25°C to 40°C.


Some common places you can find the amoebas in:

  • Water places, like  lakes and rivers

  • hot bore water

  • Very long surface pipes

  • water hoses or pipes

  • Spas or Steamer


You can get PAM from a swimming pool, which is very rare.


Primary amoebic meningoencephalitis infection happens when the water with Naegleria fowleri amoeba travels up to your nose. This may happen if you:


  • jump into water

  • dive into water

  • fall into water


The Naegleria fowleri amoebas take their own way to the brain. This Naegleria fowleri amoeba destroys the brain tissues which causes inflammation. If the water with Naegleria fowleri amoebas goes up to your nose, there is a very less chance of getting PAM.


You can’t get Primary amoebic meningoencephalitis (PAM) from:


  • If you drink water with the amoebas

  • From another person


Diagnosis


Primary amoebic meningoencephalitis or Amoebic meningitis will be diagnosed with a collection of examinations. Your healthcare provider will look at the person’s medical history and followed by a physical examination and some other specific tests.

Common test which are used to diagnose PAM are :


Blood cultures – In this test, they take blood samples from you to test the blood whether the bacteria grows in blood. And also, this blood sample can undergo a microscope to check for bacteria whether present in the blood.


Scans – There are different types of scans to diagnose the illness and diseases in the body. Healthcare professionals use scans like CT and MRI to identify anything abnormal.


Lumbar puncture (spinal tap) –  This test collects the cerebrospinal fluid. Usually, this cerebrospinal fluid which surrounds the brain and the spinal cord. Professionals test these fluids to determine the levels of key elements in the cerebrospinal fluid.


Treatment


Treatment for Primary amoebic meningoencephalitis or Amoebic meningitis must be treated as soon as it is diagnosed. Because the amoebae are usually brain-eating organisms which can multiply and it causes them to work faster. Because of this, if the early treatment of illness starts, there is a more chance of surviving. If they survive, with the help of prompt treatment there is a less risk of permanent damage.


Generally, treatment for this Primary amoebic meningoencephalitis infection is formed with the combination of different drugs which includes:


1. Conventional amphotericin B is an antifungal drug.


2. Rifampin is an antibiotic drug.


3. Fluconazole is another type of antifungal drug.


4. Miltefosine is the drug that causes birth defects in women. Still it is a chosen drug which helps you to treat the PMI because of the high mortality rate of illness. This is because, if the patient does not take the drug they might die.


5. Azithromycin is another type of different antibiotic drug.


6. Medicines like Steroid medication can also be used to reduce the swelling around the brain.


But this disease is so rare that one foolproof treatment plan won’t work to treat Primary amoebic meningoencephalitis or Amoebic meningitis (PMI). This infection has a high death rate so, Professionals provide a combination of drugs. Because of this, if one drug or medicine doesn’t work, another type of drug may work along with it.


Infected people should ensure that they had lots of fluid and medications which reduce the fever and body aches. This Primary amoebic meningoencephalitis or Amoebic meningitis (PMI) can lead to death consequences.


Prevention


If you want to stop PAM infection follow the tips:


  • You should don’t jump or dive into warm fresh water or thermal pools or private pools or resorts

  • You must keep your head above water. Places like spas, thermal pools, and warm fresh water

  • You must let them empty, clean and dry the small wading pools in the sun after every use

  • You must ensure that swimming pools and spas are chlorinated

  • You must flush still fresh water from hoses before you letting your children play with them


Frequently Asked Questions


Q1. When do PAM symptoms start?

ANs: The first symptoms of PAM usually start about 5 days after infection, but they can start within 1 to 12 days.


Q2. What does PAM do to the brain?

Ans: PAM causes inflammation and destruction of the brain and the linings of the brain, and is usually fatal.


Q3. Can you survive amoebic meningoencephalitis?

Ans: It is a rare disease that is almost always fatal and only 4 out of 154 people in the United States have survived infection from 1962 to 2021.


Q4.What is the treatment for PAM?

Ans: Primary Amebic Meningoencephalitis (PAM) is treated with a combination of drugs, often including amphotericin B, azithromycin, fluconazole, rifampin, miltefosine, and dexamethasone.


Q5.How is PAM diagnosed?

Ans: PAM can be diagnosed in the laboratory by detecting Naegleria fowleri organisms, nucleic acid, or antigens in a patient's cerebrospinal fluid (CSF) or brain tissue.

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