Digital Twins for a Rapidly Fatal Amoebic Infection: Modelling Host-Pathogen Dynamics in Primary Amoebic Meningoencephalitis Due to Naegleria fowleri

Naegleria fowleri, the “brain-eating amoebae,” causes primary amoebic meningoencephalitis, a fulminant and usually fatal infection of the central nervous system. Despite decades of research, mortality exceeds 95 percent, largely due to delayed diagnosis, rapid disease progression, and a narrow therapeutic window. Advances in molecular parasitology, neuroimmunology, and computational modelling now support precision-based approaches. Integrating clinical, molecular, imaging, and pharmacological data within a patient-specific digital twin could enable early prediction of disease trajectory and therapeutic response. Recent studies have revealed virulence factors, immune-evasion strategies, and host inflammatory pathways driving central nervous system injury. Omics-based profiling, drug repurposing, and in-silico pharmacology are identifying candidate therapeutics and data streams suitable for digital-twin integration. Herein, we synthesise current understanding of Naegleria fowleri biology, host responses, and emerging therapies, proposing a digital-twin framework to personalise disease management and transform diagnosis, monitoring, and treatment optimisation.