FatalNaegleria fowleriMeningoencephalitis, Italy

We report the first case of primary amebic meningoencephalitis in Italy, in a 9-year-old boy.Clinical course was fulminant, and diagnosis was made by identifying amebas in stained brain sections and by indirect immunofluorescence analysis.Naegleria fowleri was characterized as genotype I on the basis of polymerase chain reaction test results. P rimary amebic meningoencephalitis (PAM) is invari- ably an acute, often fulminant infection caused byNaegleria fowleri, a small, free-living ameba that occasionally infects humans and other mammals.Although rare (≈200 cases have been reported worldwide to date), PAM is frequently fatal, is difficult to diagnose, and does not have effective therapeutic options (1-5).Although more than half of PAM cases have occurred in the United States, infections have been registered in countries in every continent.In the past, cases of PAM were reported from Europe, especially from the Czech Republic, Belgium, and the United Kingdom (1).A single case of fatal opportunistic Acanthamoeba encephalitis in a patient with AIDS was documented in Italy in 1992 (6).We report the first case of PAM from Italy, diagnosed postmortem in an immunocompetent child who, most likely, acquired the infection in July 2003 after swimming in a polluted water hole of the Po River.