[Correspondence] Naegleria fowleri in Kerala, India: prevention over panic

Kerala, India, is confronting a rare but deadly cluster of primary amoebic meningoencephalitis caused by Naegleria fowleri, with about 69 confirmed cases and 19 deaths reported in 2025.1 Although uncommon, the disease is almost uniformly fatal and can progress over days. Because primary amoebic meningoencephalitis frequently mimics bacterial meningitis or viral encephalitis, diagnosis and treatment are often delayed. In some instances, it has also been mistaken for cerebral toxoplasmosis, cryptococcal meningitis, or tuberculous meningitis.