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Abstract
Naegleriafowleri, a thermophilic, free-living amoeba, is the causative agent of primary amoebic meningoencephalitis (PAM), a rapidly progressing and often fatal infection of the central nervous system. During exposure to contaminated warm freshwater, the parasite enters the human host via the nasal cavity, migrates along the olfactory nerves, and induces severe inflammation in the brain. Despite its high fatality rate (> 95 %) , effective treatment remains elusive due to delayed diagnosis and limited therapeutic efficacy. Current diagnostic approaches include microscopy, PCR, and imaging techniques, but these are seldom applied promptly to alter outcomes. Therapeutic regimens typically involve amphotericin B, miltefosine , and combination antimicrobials, although survival is rare. Recent advances in drug repurposing, nanotechnology-based delivery systems, and immunotherapeutic strategies show potential but require further validation and assessment of effectiveness. Preventive measures, including public awareness initiatives and improved water treatment, are currently the most effective means of reducing the risk of PAM. This review provides an updated synthesis of the literature focusing on the causative agent, pathogenesis, diagnostic modalities, treatment options, and prevention strategies for N. fowleri infection. Background: Naegleriafowleri is a free-living, thermophilic amoeba that causes primary amoebic meningoencephalitis (PAM), a rare but fatal CNS infection. It inhabits warm freshwater environments such as lakes and hot springs. Infection occurs when contaminated water enters the nasal cavity, allowing the amoeba to reach the brain via the olfactory nerves. With a mortality rate above 95%, early diagnosis and improved preventive strategies are critical to reduce its devastating impact.