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Primary amoebic meningoencephalitis: two new cases from Pakistan
Tropical Doctor, 09/18/09

Saleem T et al. – A 24–year–old man presented with a two–day history of high grade fever, headaches and vomiting. He was put on intrathecal amphotericin B, fluconazole and rifampicin when motile trophozoites were identified on a wet mount of cerebrospinal fluid. The patient did not improve and died on the sixth day of admission. The second case was a 30–year–old man who presented with a three–day history of high grade fever, vomiting and agitation. He received intrathecal amphotericin B, fluconazole and broad spectrum antibiotics when motile trophozoites on wet mount were observed. Again, the patient's condition did not improve and he died on the eighth day of admission.

Exclusive Author Commentary
Taimur Saleem , 09/21/09

Meningitis remains a potentially fatal condition in the developing world because of inadequate diagnostic and therapeutic facilities. Although pyogenic meningitis is more common overall, it is also important for clinicians to be cognizant of the rarer causes of meningitis such as amoebic meningoencephalitis. This is a highly fatal malady and timely diagnosis may prove to be a life-saving manoeuvre for the patients.

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