Clinicians at Seattle-based Swedish Medical Center witnessed the nation's first fatal case of a Balamuthia mandrillaris brain infection linked to improper nasal irrigation with tap water, according to a case study published in the International Journal of Infectious Diseases.
In January 2018, a 69-year-old woman presented at the hospital's emergency department after experiencing a seizure. She also had a red rash on her nose that had been incorrectly diagnosed as rosacea. A CT scan revealed what physicians initially thought was a tumor in the woman's brain.
"When I operated on this lady, a section of her brain about the size of a golf ball was bloody mush," Charles Cobbs, MD, a neurosurgeon at Swedish, told The Seattle Times. "There were these amoeba all over the place just eating brain cells. We didn't have any clue what was going on, but when we got the actual tissue we could see it was the amoeba."
Physicians suspect a rare, brain-eating amoeba entered the woman's brain after she used tap water in a neti pot to irrigate her sinuses, instead of filtered water.
"Despite aggressive and novel anti-amoebic treatment, she died as a result of a Balamuthia mandrillaris brain infection," physicians wrote in the case study.
The infection marks the second ever reported in Seattle and the first fatal case linked to nasal irrigation. Between 1974 and 2016, there have been 109 reported cases of the amoeba in the U.S., 90 percent of which were fatal, according to a separate study published in Clinical Infectious Diseases.
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