Table 1.
Epidemiological, clinical, and laboratory data of the PAM cases reviewed.
| No | Citation | Country | Age (Year) | Sex | Exposure | Symptoms | Time to Onset | Full Blood Count | CSF Result | PCR Result | Survival |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 1 | Chen et al., 2019 [33] |
China | 43 | Male | Waterpark activities; traveller | Fever; myalgia; fatigue; persistent occipital headache (for 2 days) | 5 days | Leucocytosis; CRP | Turbid; high pressure; glucose low; leucocyte high; protein high; Pandy’s test positive; trophozoites of N. fowleri with Wright–Giemsa stain | N. fowleri positive | Mortality |
| 2 | Celik and Arslankoylu 2021 [41] |
Turkey | 11-day-old | Male | History of bathing with unchlorinated well water | Fever; inability to suck; irritability; convulsion (for 2 days) | 4 days | Leucocytosis; CRP | Leucocytosis; protein high; glucose low; negative for microbial growth, TORCH, acid-resistant bacilli, Ziehl–Neelsen staining | N. fowleri positive | Mortality |
| 3 | Ravinder et al., 2016 [31] |
India | 15 | Male | Bathing in unclean village pond | Fever; vomiting; left-sided body weakness; convulsion; sudden loss of consciousness; jerky bilateral hand movement | No data | Leucocytosis | Direct microscopy—flagellated parasite and spherical budding yeast cells; latex agglutination test was positive for Cryptococcal antigen | Not performed | Survive at point of time |
| 4 | Chomba et al., 2017 [42] |
Zambia | 24 | Male | Swimming in river; police recruit at training camp | Fever; convulsion | 2 days | No data | No bacterial or fungal pathogens were detected in CSF day 1 and day 3; numerous highly motile amoebic trophozoites and cysts day 8 |
N. fowleri positive | Mortality |
| 5 | Stowe et al., 2017 * [22] |
USA | 4 and 14 | Male | (1) Camping and swimming at lake | (1) Fever; convulsion; headache, vomiting; difficulty ambulating; altered mental status; (2) generalised muscle weakness; tactile fever; vomiting; confusion; convulsion | Both 8 days | No data | Grossly abnormal; (1) free-swimming amoebae |
N. fowleri positive | Mortality |
| 6 | McLaughlin and O’Gorman 2019 [35] |
Australia | 56 | Male | Swimming in stagnant water that was also accessed by cattle; irrigating nostrils | Headache; photophobia; nausea; vomiting; neck stiffness | No data | No data | Turbid; glucose low; protein high; leucocytosis; free-living amoebae | N. fowleri positive | Mortality |
| 7 | Cope et al., 2018 [27] |
USA | 18 | Female | Freshwater swimming; water rafting activities | Fever; headache; lethargy | 14 days | No data | High pressure; leucocytosis; glucose low; protein high; wet mount of the CSF revealed possible motile trophozoites | N. fowleri positive, with concomitant detection of Balamuthia mandrillaris and Acanthamoeba spp. | Mortality |
| 8 | Sazzad et al., 2020 [36] |
Bangladesh | 15 | Male | Bathing and contact with untreated ground water and river; irrigating nostrils | Fever; generalised headache; vomiting; weakness; neck stiffness; unconscious | No data | No data | Protein high; glucose low; leucocytosis; negative Ziehl–Neelsen stain and acid-fast bacilli | N. fowleri positive | Mortality |
| 9 | Stubhaug et al., 2016 [38] |
Norway | 71 | Female | Travel to Thailand where hotel was supplied with untreated groundwater well; irrigating nostrils | Nausea; vomiting; fever; fatigue; | No data | Leucocytosis; CRP | Turbid; pressure high; glucose low; protein high; leucocytosis; negative nigrosin, acridine orange stain; equivocal cryptococcal latex antibody | N. fowleri positive | Mortality |
| 10 | Baral and Vaidya 2018 [37] |
Nepal | 74 | Male | Nil | Fever; global headache; feature of anomic aphasia but no vomiting, seizure, or neurological deficit at presentation; altered sensorium and agitation; gradual weakness of bilateral lower limb and trunks | No data | No data | Leucocytosis; protein high; glucose low; negative for microbial growth, TB, AFB, HSV | Not performed | Mortality |
| 11 | Johnson et al., 2016 [24] |
USA | 21 | Female | Swimming in private pool in a desert environment—not being chemically treated. Water supplied to the pool was from a mountain spring | Headache; nausea; vomiting; | 14 days | No data | Not mentioned | N. fowleri positive | Mortality |
| 12 | Huang et al., 2021 [34] |
China | 8 | Male | Swimming in lake | Fever; headache; vomiting; altered consciousness; convulsion | 3 days | Leucocytosis; CRP | Leucocytosis; glucose low; protein high; pale, pink, thick necrotic fluid drawn out from the syringe |
N. fowleri positive | Mortality |
| 13 | Mushtaq et al., 2020 [39] |
Pakistan | 44 | Male | Not mentioned | Fever; worsening headache; generalised weakness | No data | Leucocytosis; | Leucocytosis; negative Gram stain, India ink, cryptococcal antigen; positive wet prep for Naegleria | N. fowleri positive | Mortality |
| 14 | Mittal et al., 2019 [32] |
India | 8 months | Female | Nil | Fever; chills; rigors; abnormal body movement; vomiting; generalised tonic–clonic seizures; decreased oral intake; decrease urine output | No data | Microcytic hypochromic anaemia; raised CRP | High pressure; protein high; glucose low; leucocytosis; wet mount positive for moving trophozoites of amoeba; negative for India ink, Gram stain | N. fowleri positive | Survive at point of time (AOR) |
| 15 | Yadav et al., 2013 [29] |
India | 25-day-old | Male | Untreated water well used for bathing | Fever; reduced feeding; multi-focal seizures (for 10 days) | No data | Leucocytosis; CRP | Leucocytosis; glucose low; protein high; CSF wet mount examination revealed presence of free-living motile amebae |
Not performed | Survival |
| 16 | Dunn et al., 2016 [25] |
USA | 12 | Female | Swimming at freshwater park | Fever; headache; lethargy; nausea; vomiting | 7 days | Leucocytosis | Milky colour; high turbidity; leucocytosis; Giemsa stain positive for Naegleria spp. | N. fowleri positive | Survival |
| 17 | Sood et al., 2014 [30] |
India | 6 | Male | Collateral history—the boy played frequently with water stored in a cement tank used for varied purposes. The water was collected from a nearby diversion channel called “kuhl” | Fever; headache; altered sensorium | No data | Raised ESR | Clear colour; leucocytosis; negative Gram stain, India ink, Ziehl–Neelsen; positive wet mount revealed amoebic and flagellate trophozoites | Not performed | Survival |
| 18 | Cope et al., 2015 [23] |
USA | 4 | Male | Water exposure: tap water that was used to supply water to a lawn water slide on which the child had played extensively | Diarrhoea; vomiting; poor oral intake; severe headache; fever; convulsion; lethargy | No data | Leucocytosis | Colourless; pressure high; protein high; leucocytosis; negative Gram stain | N. fowleri positive | Mortality |
| 19 | Anjum et al., 2021 [28] |
USA | 13 | Male | Swimming at water park—untreated water supply | Headache; fever; intractable emesis; poor oral intake | 3 days | Leucocytosis; raised CRP | Pressure high; turbid; glucose low; protein high; leucocytosis; EVD protein high; Wright–Giemsa stain showed amoebic trophozoites | N. fowleri positive | Mortality |
| 20 | Su et al., 2013 [40] |
Taiwan | 75 | Male | Thermal hot spring | Fever; headache; right arm myoclonic seizure; right-sided limb weakness | No data | Leucocytosis; raised CRP | Turbid; glucose low; protein high; leucocytosis; negative for India ink, Gram stain, AFB, fungi, viral; wet mount smear positive for trophozoites | N. fowleri positive | Mortality |
| 21 | Heggie and Küpper 2017 [26] |
USA | 12 | Female | Swimming at lake-based water park (shallow depth and sandy bottom) | Fever; vomiting; headache; difficulty waking up from sleep; difficulty holding head up; unable to open eyes; hallucination | Less than 1 week | No data | N. fowleri | Not performed | Survival |
* The article consists of two cases (a case series). CRP = C-reactive protein.