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Doctor: Seattle woman who died of brain-eating amoeba used tap water in Neti pot

Magnified 1180X, this 1973 H&E-stained photomicrograph revealed the presence of Naegleria gruberi, free-living amoebae in a human brain tissue specimen, in a case of primary amoebic meningoencephalitis (PAM). 

SEATTLE — A Seattle woman died after becoming infected with a brain-eating amoeba.

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The woman told her doctor she had used tap water in a Neti pot, instead of saline or sterile water, reported KIRO-TV. Doctors believe an amoeba entered in through her upper nasal cavity and got into her bloodstream, eventually reaching her brain.

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A neurosurgeon from Swedish Medical Center 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. The directions call for boiled or distilled water. They believe the woman used tap water she'd put in a pitcher with a filter.

Dr. Charles Cobbs is the neurosurgeon who operated on the patient in January 2018. The 69-year-old woman arrived in the hospital's emergency room after suffering seizures. At first, doctors thought the woman had a tumor; she had been previously diagnosed with breast cancer. She also had a sore on her nose that would not go away. While it had been biopsied, no one suspected an amoeba.

When Dr. Cobbs first operated on her, he discovered a tumor the size of a dime. He removed it and sent a sample to a lab at John's Hopkins for a second opinion. The woman's condition quickly deteriorated.

The pathologist discovered it was an amoeba. About two weeks later, Dr. Cobbs did another surgery, about two weeks after the first surgery, and found a mass the size of a baseball. He removed the mass and put the woman on a large dose of medicine. Infectious disease doctors at Swedish Medical Center contacted the Centers for Disease Control in Atlanta and they sent medicine for the woman. Doctors gave it to her but she could not be saved.

"She had not been boiling water, using sterile water or using sterile saline. 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. So that's what we suspect is the source of the infection," Dr. Cobbs told KIRO-TV. "This is so rare, there have only been like 200 cases ever."

Now they think the sore on her nose was connected. Swedish Medical Center doctors wrote a case study for the International Journal of Infectious Diseases to educate other doctors on their rare findings.

"I believe it actually got in the bloodstream and somehow ended up in the brain. Because it wasn't directly from the nose to the brain, it somehow ended up in the brain way back here," said Dr. Cobbs, pointing to the back of his head.

Dr. Cobbs says people should follow the directions on the Neti pot and use boiled or distilled water.
"It's not something to be scared about because it's extraordinarily rare, but still there's a lot to learn, " added Dr. Cobbs.