Health Minister Veena George hailed the achievement as a milestone for Kerala’s public health system and congratulated the doctors for “exemplary teamwork and excellence in treatment.”
Published Sep 03, 2025 | 6:14 PM ⚊ Updated Sep 03, 2025 | 6:14 PM
Naegleria fowleri infects people by entering the body through the nose, usually while swimming. The amoeba travels up the nose to the brain where it destroys the brain tissue and causes swelling of the brain. (Creative Commons)
Synopsis: Globally, PAM is one of the deadliest infections known to medicine, with a staggering 99 percent mortality rate. The disease is caused by free-living amoebae found in soil and contaminated water that attack the brain and spinal cord. Kerala, however, has managed to bring down mortality to 24 percent through early detection, state protocols, and specialist care. Meanwhile, doctors said this particular case was exceptionally complex.
In what doctors describe as a world-first, a 17-year-old student from Kollam has survived a simultaneous attack of primary amebic meningoencephalitis (PAM), a rare brain infection caused by Naegleria fowleri, and Aspergillus flavus fungal infection of the brain, thanks to timely intervention by medical teams in Alappuzha and Thiruvananthapuram Government Medical Colleges.
The boy, who contracted the rare infections after having a bath in a pond three months ago, was discharged from the Thiruvananthapuram Medical College Hospital in perfect health.
Health Minister Veena George hailed the achievement as a milestone for Kerala’s public health system and congratulated the doctors for “exemplary teamwork and excellence in treatment.”
Globally, PAM is one of the deadliest infections known to medicine, with a staggering 99 percent mortality rate. The disease is caused by free-living amoebae found in soil and contaminated water that attack the brain and spinal cord.
Kerala, however, has managed to bring down mortality to 24 percent through early detection, state protocols, and specialist care. Meanwhile, doctors said this particular case was exceptionally complex.
A week after the bathing episode, the teenager developed symptoms including loss of consciousness, weakness on the left side, and later, blurred vision.
The initial diagnosis of amoebae in his cerebrospinal fluid at Alappuzha Medical College, led by Dr Shanimol and her team in microbiology, was crucial in starting timely treatment.
When his condition deteriorated due to increased pressure in the brain, he was shifted to Thiruvananthapuram Medical College.
MRI scans revealed multiple pus-filled lesions, prompting an emergency neurosurgery led by Dr Sunil Kumar, along with a team of specialists in medicine, infectious diseases, and microbiology. A second operation followed when the infection worsened. Tests on the drained pus confirmed the presence of Aspergillus flavus, a fungal pathogen that rarely coexists with amoebic encephalitis.
“Correct early diagnosis and timely surgeries were crucial,” said a member of the team who diagnosed the teen.
Intensive antifungal and anti-amoebic therapy continued for over six weeks before the patient made a full recovery.
While the successful recovery has boosted confidence in Kerala’s treatment protocols, doctors remain concerned about the recent surge in amoebic encephalitis cases.
Data from the Health Department show that 86 cases were reported in the state over the past two years—39 last year (2024) and 47 this year—resulting in 21 deaths.
The sharp rise has left experts puzzled. “Why so many cases are being reported in Kerala, while they remain rare elsewhere, is still not fully understood,” said a senior microbiologist.
Some point to environmental changes, poor water quality in stagnant ponds, and increased human exposure to contaminated water bodies as possible reasons.
Others say improved detection in Kerala’s medical colleges, equipped with microbiology labs and state-level testing facilities, may partly explain the rise.
To curb the spread, the state has launched preventive steps, including chlorination drives in wells and ponds under the Haritha Kerala Mission.
Special guidelines have also been issued for early diagnosis, and doctors in peripheral hospitals are being sensitised to detect the disease quickly.
Still, public health experts caution that the disease remains a formidable threat. “We are able to save more lives now, but amoebic encephalitis is unpredictable and aggressive. Prevention and awareness are key,” said a microbiologist at a Government Medical College.
For the 17-year-old and his family, however, the ordeal has ended with hope.
After three months of intensive treatment and care, he returned home healthy—a rare survivor of two of the deadliest brain infections known to medical science.
(Edited by Sumavarsha, inputs from Sreelakshmi Soman)
