Fatal Brain Infection Linked To Neti Pot Use In Case Report

The use of tap water through a neti pot resulted in a fatal infection involving a brain-eating amoeba, according to a new medical case report. 

Researchers from Sweden published the report in the International Journal of Infectious Diseases last week, indicating that a 69-year-old woman from Seattle died a year after trying to irrigate her sinuses with a neti pot, due to a balamuthia mandrillaris brain infection.

The unidentified woman developed a chronic sinus infection, and turned to neti pots after medication failed to provide relief, according to the report. However, the researchers note that she used tap water that was filtered through a Brita Water Purifier, instead of the recommended sterile water or saline.

A month after she used the neti pot, which did not resolve her original symptoms either, she developed a red rash on the bridge of her nose and raw red skin at the opening to her nostril.

Dermatologists failed to properly diagnose the rash, and a year later she suffered seizure and ultimately died due to the damage the amoebas had done, with doctors at the time saying they found a golf-ball sized-hole where the amoebas had eaten away her brain.

There have only been 109 cases of the amoeba reported in the U.S. since 1974, however, 90% of the cases are fatal.

This is not the first time brain-eating amoebas have been linked to the use of neti pots. In December 2011, health officials in Louisiana issued a public health warning regarding two deaths linked to different amoeba called Naegleria fowleri. In both of those cases, the individuals had been using neti pots with tap water as well.

“Improper nasal irrigation has been reported as a method of infection for the comparably insidious amoeba N. fowleri. This precedent led us to suspect the same route of entry for the Balamuthia amoeba in our case,” the researchers noted. “While Balamuthia and Naegleria share some similarities, Balamuthia is more difficult to detect.”

Neti pots are small devices used for nasal irrigation, in which the nasal cavity is washed to flush out excess mucus and debris in the nose or sinuses. Only sterile water or water made sterile by boiling first should be used in the pots, officials warn. After use the pots should be rinsed clean and left to air dry.

Researchers in this latest study warned doctors to be aware of the risks, the presentation of nasal rashes after sinus irrigation and to use resources by the U.S. Centers for Disease and Prevention (CDC) for detecting amoeba genes in skin lesions and brain tissue biopsies if patients develop rashes or brain problems after using neti pots.