Abstract：
Primary amebic meningoencephalitis (PAM) is a necrotizing and hemorrhagic inflammation of the brain and meninges caused by Naegleria fowleri, a free-living thermophilic ameba of freshwater systems. PAM remains a neglected disease that disproportionately affects children in tropical and subtropical climates, with an estimated mortality rate of 95-98%. Due to anthropogenic climate change, the average temperature in the USA has increased by 0.72 to 1.06 °C in the last century, promoting the poleward spread of N. fowleri. PAM is often misdiagnosed as bacterial meningitis or viral encephalitis, which shortens the window for potentially life-saving treatment. Diagnosis relies on the patient\'s history of freshwater exposure and the physician\'s high index of suspicion, supported by cerebrospinal fluid studies. While no experimental trials have been conducted to assess the relative efficacy of treatment regimens, anti-amebic therapy with adjunctive neuroprotection is standard treatment in the USA. We performed a literature review and identified five patients from North America between 1962 and 2022 who survived PAM with various degrees of sequelae.
摘要：
原发性阿米巴脑膜脑炎(PAM)是一种由福氏Naegleria引起的脑和脑膜的坏死性和出血性炎症,淡水系统的自由生活的嗜热阿米巴。PAM仍然是一种被忽视的疾病，在热带和亚热带气候下对儿童的影响不成比例，估计死亡率为95-98%。由于人为气候变化,美国的平均气温在上个世纪上升了0.72到1.06°C,促进N.Fowleri的极地传播。PAM常被误诊为细菌性脑膜炎或病毒性脑炎，这缩短了可能挽救生命的治疗窗口。诊断依赖于患者的淡水暴露史和医生的高怀疑指数，由脑脊液研究支持。虽然尚未进行实验性试验来评估治疗方案的相对疗效，辅助神经保护的抗阿米巴治疗是美国的标准治疗方法。我们进行了文献综述，并确定了1962年至2022年之间来自北美的五名患者，他们在PAM中幸存下来，并有不同程度的后遗症。
