A woman who was told to rinse out her sinuses twice daily for the treatment of her sinus infection has died from a brain-eating amoeba.
Is neti pot use to blame for her death?
Neti Pot For Sinus Infection
A year prior to her brain infection diagnosis, a 69-year-old woman from Seattle with a distant history of breast cancer developed chronic sinus infection. After medications proved to be unhelpful in symptom relief, it was suggested that she use saline nasal irrigation twice a day to clear her sinuses.
Typically, nasal irrigation is recommended to be used with either sterile water or with saline solution, but the woman merely used filtered tap water.
Red Rash On The Nose
About a month after using the nasal irrigation using filtered tap water, the woman developed a red raised rash on her nose as well as raw red skin at her nasal opening. Initially, doctors diagnosed her with rosacea and gave her an ointment for treatment, but her symptoms did not disappear.
For a year, the woman kept going back to doctors, but no specific diagnosis could be made.
Focal Seizure
A year after developing the rash, the woman was seen outside the hospital, experiencing a left upper extremity focal seizure. While she was conscious during the entire episode, she experienced generalized left side shaking as well as loss of cognition. Doctors performed a biopsy on her brain cells and sent her home after two days with anticonvulsants, but she came back just days later, complaining of left arm and leg numbness.
On the 15th day after the initial operation and biopsy of her brain, she was re-admitted to the hospital. She had an “altered mental status,” and tests performed on her revealed an expanded mass suggesting hemorrhage or fluid accumulation as well as some focal seizure activity.
Brain-Eating Amoeba
Days later, a consulting neuropathologist at Johns Hopkins University suggested the possibility of an amoeba infection, which was confirmed that very same day through re-resection of her expanding right frontal motor cortex mass.
Her doctors immediately called the Centers for Disease Control and Prevention, and within 24 hours, the proper medications were already delivered to the hospital. Unfortunately, the patient continued to deteriorate and eventually went into comatose. She died after her family decided to withdraw support.
Testing after her death confirmed the presence of Balamuthia mandrillaris, an amoeba that can be found in the environment and typically enters the body either through contact with an open cut or wound, or when infected dust is breathed in or enters the mouth. It can then go to the brain through the blood stream and cause granulomatous amebic encephalitis, a very rare disease that is often fatal.
Neti Pot Use
So did her neti pot use contribute to her death? There have been reports of improper nasal irrigation as a means of infection, particularly of the comparably dangerous ameba, N. fowleri. It is because of this that doctors suspect it may be the same route that B. mandrillaris took to enter her body. That said, the water in her home was not tested.
“Our ability to definitively trace the patient’s infection to improper nasal lavage is limited,” the authors wrote.
The report is published in the International Journal of Infectious Diseases.
