Lillian Smart, an 8-year-old girl from Ruston, Louisiana, has died after developing a rare and usually fatal brain infection linked to the amoeba Naegleria fowleri, according to her family and local health officials.
Lillian died Saturday, Aug. 22, one day after her eighth birthday, according to a statement from her family shared on the “Love for Lillian” Facebook page. Her family said the injuries to her brain had become too severe for her to recover.
Lillian had been hospitalized since Aug. 15. The Louisiana Department of Health confirmed on Aug. 19 that a Louisiana resident had contracted Naegleria fowleri and said the infection was most likely acquired while the person was swimming in Lake Claiborne in Claiborne Parish, about 30 miles northwest of Ruston.
Health officials did not publicly identify the patient in their alert. Local reporting and statements from Lillian’s family later identified her as the child who had been hospitalized with the infection.
Lillian’s illness progressed quickly
According to a post previously shared by Lillian’s mother, the child initially developed a fever before experiencing double vision and being admitted to intensive care.
Her family later reported significant swelling of the brain caused by the infection.
The family announced her death Sunday, writing that the brain injuries were too severe for her body to overcome.
Lillian’s illness also drew support from the Ruston community. Local businesses organized a fundraiser around her birthday, with proceeds intended to help the family during her hospitalization. Local reporting described Lillian as a child known in the community for her cheerful personality.
What is Naegleria fowleri?
Naegleria fowleri is a microscopic amoeba that naturally occurs in warm freshwater. In extremely rare cases, water containing the amoeba can enter through the nose and allow it to reach the brain, causing a disease known as primary amebic meningoencephalitis, or PAM.
The infection is not spread from person to person, and swallowing water containing the amoeba does not cause the infection. Most U.S. cases have been associated with swimming or other activities in warm freshwater during the summer months.
The Louisiana Department of Health said the infection is extremely rare but nearly always fatal. CDC data show that 180 cases were diagnosed in the United States from 1937 through 2025, with between zero and eight cases reported in a typical year.
Symptoms can become severe within days
Early symptoms of PAM can include headache, fever, nausea and vomiting. As the infection progresses, patients can develop a stiff neck, confusion, seizures, hallucinations and coma. The CDC says symptoms usually begin about five days after exposure but can appear anywhere from one to 12 days afterward.
The infection can be difficult to recognize because its early symptoms can resemble more common illnesses. The CDC says PAM progresses rapidly and that death can occur within one to 18 days after symptoms begin.
Health officials urge caution around warm freshwater
The CDC says people should take precautions when swimming in warm freshwater because there is no reliable way to know whether a particular lake or river contains Naegleria fowleri.
Holding the nose shut or using a nose clip can reduce the amount of water that enters the nose. The CDC also advises avoiding activities that stir up sediment in shallow, warm freshwater.
The agency says the overall risk remains extremely low, but infections that do occur are serious and require immediate medical attention when symptoms develop after freshwater exposure.
Lillian’s death comes less than a week after Louisiana health officials first announced the Lake Claiborne-linked infection. Her family has asked for prayers and support as they mourn the loss of their daughter.
