One American survived the infection in 1978 and one individual from Mexico in 2003. In 2013, two children survived and recovered from primary amoebic meningoencephalitis after treatment with miltefosine. In 2016 after treatment that included miltefosine, another child became the fourth person in the United States to survive Naegleria fowleri infection. Society and culture
Availability
Since 2017 Miltefosine is commercially available in the United States through Profounda. Previously one could only get it from the CDC for emergency use under an expanded access IND protocol for treatment of free-living amoeba (FLA) infections: primary amoebic meningoencephalitis caused by Naegleria fowleri and granulomatous amoebic encephalitis caused by Balamuthia mandrillaris and Acanthamoeba species. Miltefosine is almost exclusively produced by Profounda, a private pharmaceutical company. Economics
In the developing world a course of treatment costs US$65 to $150. In the developed world treatment may be 10 to 50 times greater. Further research
It is active against some bacteria and fungi, as well as human trematode Schistosoma mansoni and the snail that spreads it Biomphalaria alexandrina. Antiprotozoal and antifungal activities
Miltefosine is being investigated by researchers interested in finding treatments for infections which have become resistant to existing drugs. Animal and in vitro studies suggest it may have broad anti-protozoal and anti-fungal properties:

Animal studies suggest miltefosine may also be effective against Trypanosoma cruzi, the parasite responsible for Chagas disease. Several studies have found the drug to be effective against types of fungus: Cryptococcus neoformans, Candida, Aspergillus and Fusarium.
recommending that the patient be fit with custom orthotics if they are overprone). Fortunately, subluxed cuboids are generally quite treatable and most patients return to a normal level of activity once the pain is brought under control. See also
Arthritis
Physiatry
Rheumatology
Tarsal tunnel syndrome


== References ==