Primary amoebic meningo-encephalitis is a fulminant, often rapidly fatal infection affecting individuals with a recent history of swimming in warm fresh water. A fatal case of primary amoebic meningoencephalitis due to Naegleria fowleri in a 35 years old male suffering from human immunodeficiency virus with pulmonary tuberculosis infection is reported. Naegleria fowleri was diagnosed by wet mount examination of cerebrospinal fluid and the diagnosis was confirmed by culture of the cerebrospinal fluid on non-nutrient agar layered with Escherichia coli. The patient was treated with amphotericin B and antituberculous treatment but the outcome was fatal. Primary amoebic meningo-encephalitis should be suspected in every case of pyogenic meningo-encephalitis in which no bacteria or fungus is found on cerebrospinal fluid examination.
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