In what is clearly an unusual event, the Times of India are reporting on the survival of a 14-year-old boy from the very lethal primary amoebic meningoencephelitis or PAM caused by the amoebic parasite, Naegleria fowleri.

Public domain photo/Robin klein
Public domain photo/Robin klein

The Kolkata teen is believed to have contracted the “brain-eating amoeba” while swimming.

He was treated by a team of doctors who used a combination of drugs:

“The principal drug -amphotericin B -is very toxic. It was used along with three other drugs but the child suffered a kidney failure, a common side effect. Then, we had to act very fast. The principal drug was discontinued and we decided to try three other drugs that have been used in recent PAM cases elsewhere. One of these was Miltefosine, a new drug not yet widely available in the market but very effective,” said Sushmita Banerjee, paediatric nephrologist at CMRI.

The health department was approached for the drug and the directorate of health procured it quickly .

After two weeks of being used in combination, the cocktail of medicines managed to control the infection. His kidneys stabilized and other symptoms like headache and vomiting gradually re ceded. By the end of the third week, he was declared fit to leave the hospital.

TOI reports this is the fifth PAM survivor in India.

In 2013, Arkansas teen Kali Hardig survived a parasitic meningitis infection, in which part of the treatment regimen was Miltefosine.

Naegleria fowleri is a relatively rare, pathogenic amoeba found in warm or hot freshwater like lakes, rivers and hot springs. It is also possible to get it from dirty unchlorinated or under-chlorinated swimming pools. This parasite is found worldwide.

People typically get it by swimming, jumping or playing in freshwater and get the water up their nose. From there the parasite travels to the brain and spinal cord and necrotizes or basically eats brain tissue. The disease is known as primary amoebic meningoencephalitis (PAM) and it has a very rapid progression.

Typical symptoms may start after a day or two; headache, fever, nausea and vomiting. Later symptoms may include seizures, irrational behavior, hallucinations and finally coma and death. The course of the disease typically last about a week. Because the symptoms are very similar to bacterial meningitis, PAM may not even be considered in the diagnosis.

You cannot be infected with Naegleria fowleri by drinking contaminated water and the amoeba is not found in salt water.