Apichat Chumtong; Buddhachinaraj Phitsanulok Hospital2011-02-162011-02-162009-01-162009-01-16Buddhachinaraj Medical Journal; Vol.26 No.3 September-December 2009; 296http://imsear.searo.who.int/handle/123456789/130368In general, amoebic meningoencephalitis is caused by Naegleria fowleri, Acanthamoeba spp and Balamuthia mandrillaris. This disease is rare and difficult to diagnose. A 61-year-old male patient without a history of environmental freshwater contact was reported. The patient was admitted to Buddhachinaraj Phitsanulok Hospital with a chief complaint of severe headache, fever and confusion. Computerized tomography (CT) scan of brain showed patchy hypodense lesion at left temporo-occipital lobe. However, CSF findings showed no fungal and no bacterial pathogen. Intravenous antibiotics and antiviral agents were given. The CT scan of brain was repeated and revealed increased hypodense lesion and intracerebral hemorrhage with brain herniation. Then a craniotomy for the left temporal lobectomy was completed. Trophozoites and cysts of amoeba were detected in thehistopathological examination. The clinical condition did not improve and the patient died in twelve days of admission. Thus, amoebic meningoencephalitis should be suspected when the patient has not responded to the conventional medication even though there is no history of environmental freshwater contact. en-USBuddhachinaraj Medical JournalCase Report