Amoebic meningoencephalitis: Kozhikode man’s death highlights risk of other deadly infections

Kozhikode, Kerala:  As cases of amoebic meningoencephalitis continue to be reported in Kerala, people with compromised immunity need to be particularly cautious. Experts say that in such individuals, other infections are sometimes found alongside amoebic meningoencephalitis, which can cause the illness to worsen rapidly and significantly increase the risk of death.

What is bacterial meningitis?

Fever caused by infections affecting the brain due to viruses, bacteria or fungi is generally referred to as bacterial meningitis. The infection found in the Puthiyangadi resident was pneumococcal meningitis, which falls under this category. This represents a co-infection — the presence of one infection along with another

How are co-infections detected?

A resident of Puthiyangadi who died in Kozhikode recently after contracting amoebic meningoencephalitis was also suffering from pneumococcal meningitis, according to Dr Ummer Karadan, head of the neurology department at Baby Memorial Hospital, Kozhikode.

The Puthiyangadi native, Sachidanandan, initially developed ear pain, a symptom not usually seen in typical cases of amoebic meningoencephalitis. He consulted an ENT specialist and took medication. However, a day later the ear pain returned, accompanied by severe headache, following which he was admitted to hospital. By then, the patient had lost consciousness and was also showing signs of seizures.

He was first taken to the Beach Hospital and, after being referred from there, was admitted to a private hospital and later to Baby Memorial Hospital. “By the time the patient was put on a ventilator, he had vomiting and a mild fever. However, the severe symptoms usually seen in amoebic meningoencephalitis were less pronounced in this patient. He had only a slight fever, and there was no stiffness of the neck muscles. But based on the symptoms, we suspected amoebic meningoencephalitis and sent a cerebrospinal fluid sample for a wet mount test, which came back positive,” Dr Ummer Karadan said.

However, the question of how the ear pain had developed led doctors to suspect the presence of another infection as well. A biofire test conducted to check for co-infection subsequently confirmed pneumococcal meningitis, Dr Ummer said. Treatment for both conditions was started, and the patient was later transferred to another private hospital. However, Sachidanandan died while under treatment on January 6.

Dr K G Sajeethkumar, principal of the Government Medical College, Kozhikode, also said that similar cases of bacterial meningitis had previously been reported among some patients who were treated for amoebic meningoencephalitis at the medical college.