Fatal consequences of freshwater pearl diving

Polymerase chain reaction (PCR) amplification targeting the 18s RNA gene was done retrospectively.1 The PCR amplicon was sequenced and confirmed to have 100% homology with the 18s RNA gene of Naegleria fowleri, which is the cause of primary amoebic meningoencephalitis. Within the central nervous system N fowleri amoebae cause an intense inflammatory reaction accompanied by necrosis and haemorrhage.3 Amoebic meningoencephalitis seems to be increasing in frequency with an expanding geographic footprint.4,5 Clinical and CSF findings are difficult to distinguish from bacterial meningitis.5 A history of freshwater exposure and symptoms such as the loss of the sense of smell should prompt consideration of the disease.4 The infection has a very high case-fatality rate and very few survivors have been documented.