Are there any successful treatments for primary amebic meningoencephalitis?
It is hard to say, because these infections are nearly uniformly fatal. Only 5 survivors of PAM have been reported; this represents approximately 3% of reported cases. The high mortality rate is likely because of the difficulty of diagnosis and poor-to-marginal response to therapy. The treatment of choice is amphotericin B, at maximally tolerated doses, with adjunctive rifampin and doxycycline. Successful treatment may also require intrathecal amphotericin B. Sulfisoxazole, phenothiazine, and qinghaosu may have some benefit. Studies have suggested some role for azithromycin as an adjunct to amphotericin B. The effectiveness of these treatments remains unproven. A successful treatment results in a patient who is not dead. Depending on the extent of CNS injury, complications vary among the rare survivors of these infections.
