AUTHOR=Dai Ling , Guo Xin-Ru , Chen Xu-Rui , Ma Ming-Hao , Liu Zi-Han , Lai Juan , Lu Jun , Feng Ming , Liu Xi-Xia , Yang Sheng-Hui TITLE=A review of the mechanism, diagnosis, and treatment of Naegleria fowleri infection JOURNAL=Frontiers in Microbiology VOLUME=Volume 16 - 2025 YEAR=2025 URL=https://www.frontiersin.org/journals/microbiology/articles/10.3389/fmicb.2025.1686695 DOI=10.3389/fmicb.2025.1686695 ISSN=1664-302X ABSTRACT=Naegleria fowleri is a rare pathogen responsible for primary amoebic meningoencephalitis (PAM), a fatal central nervous system infection characterized by rapid clinical progression and an extremely high mortality rate. The existing diagnostic methods are insufficiently sensitive, and therapeutic options are minimal, making early recognition and intervention extremely challenging. This review systematically examines the biological characteristics and pathogenic mechanisms of this pathogen, as well as current diagnostic and treatment strategies, with a particular focus on the groundbreaking applications of emerging technologies such as metagenomic next-generation sequencing (mNGS) in the diagnosis of difficult-to-treat infections. The aim is to provide theoretical support and practical guidance for rapid identification, accurate diagnosis, and timely intervention in clinical practice, serving as a reference for the prevention and treatment of N. fowleri infections.