A rare amoeba (called Balamuthia mandrillaris) was feasting on her brain, according to a recent study published in the International Journal of Infectious Diseases (IJID). There have been reports of improper nasal irrigation as a means of infection, particularly of the comparably unsafe ameba, N. fowleri. Doctors performed surgery to remove the mass, which they say had "unusual characteristics". It was microscopic amoebas that were feasting on her brain. The woman told her doctor she had used tap water in a Neti pot, instead of saline or sterile water, CBS affiliate KIRO reports.
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.
An amoeba is a single-cell organism that can cause fatal disease in humans, and they live in warm soil and water. There were three similar US cases from 2008 to 2017. Since 1993, the CDC says, there have been at least 70 cases in the United States. That report found there have been 109 cases of the amoeba reported in the US between 1974 and 2016. The sores were originally diagnosed as rosacea, according to the Seattle Times. She had been using water that had been put through a filter and maybe it had been sitting there and somehow the amoeba from somewhere else got in there. Researchers believe that she contracted the amoeba while using the neti pot because she used filtered tap water rather than saline or sterile water, the latter of which is recommended. "I suspect it was in her nasal passages and skin in the nose, and, after a while, enough of it was around that it got into the bloodstream and probably went to the brain", explained Dr. Cobb the situation of the Seattle woman. There, doctors took a CT scan of her brain and discovered what they believed was a tumour.
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"It's such an incredibly uncommon disease it was not on anyone's radar that this initial nose sore would be related to her brain", Piper said.
A neurosurgeon from Swedish Medical Center in Seattle said this is a rare situation but is warning patients to be sure to follow the directions when using a Neti pot for nasal congestion, and use only boiled or distilled water. That's a type of amoeba that moves more slowly and can take weeks or months to cause death. "Pathologists couldn't really determine what it was because the tissue had been pretty much destroyed", said Dr. Charles Cobbs from the Seattle's Swedish Medical Center.