The researchers said that the woman probably filled the amoebae with water to fill a neti pot rather than using saline or sterile water. The organisms entered her brain after the water reached nerves in her upper nasal cavity.
When a 69-year-old Seattle woman underwent brain surgery at the Swedish Medical Center earlier this year, her doctors were stunned.
Last January The woman was admitted to the hospital emergency room after a seizure. The doctors did a CT scan of their brain to find out the cause and found that they initially found a tumor. However, an examination of the tissue taken during surgery during a surgical procedure showed that she had a much more deadly attack that had been going on for about a year, literally keeping her alive.
"When I operated on this woman, a section of her brain the size of a golf ball was bloody pulp," Dr. Charles Cobbs, neurosurgeon at Swedish, in a telephone interview. "There were these amoebas everywhere that were eating brain cells. We had no idea what was going on, but when we had the actual tissue we could see that it was the amoeba.
The woman died a month later from the rare organisms that entered her brain injected into her nasal cavity via a neti pot, a teapot-shaped product used to rinse out the sinuses and nasal cavity, according to a recent case study published in the International Journal of Infectious Diseases. [1
The woman's infection is the second in Seattle that was reported for the first time in 2013, but the first death caused by it. In 1990, researchers first became aware that this type of amoeba can cause disease in humans, according to a study published in November in Clinical Infectious Diseases. This report found that there were 109 cases of amoebae reported in the United States between 1974 and 2016. Ninety percent of these cases were deadly.
Amoebae are single-celled organisms, some of which can cause disease. As they thrive in warm soils and water, some local doctors are worried that the lethal infection of the woman could be among other diseases of the southern hemisphere that spread north to the Pacific Northwest with warming temperatures. The organisms are often found in South America and Central America, but may now have better chances of survival at other, usually cooler places like Washington.
"" I think we're going to see much more infections that we see (move) to the south as our environment warms up, "said Cynthia Maree, a Swedish infectious disease doctor who conducted the case study written about the condition of the woman in common. "Given the mortality associated with this infection, I hoped I was wrong. But I was afraid I was right.
The Seattle woman was probably infected with the amoebas from their tap water the researchers said. Instead of filling her neti pot with saline or sterile water, she used tap water filtered through a store-bought water filter. Then she shot the contaminated water far into the nasal cavity to olfactory nerves in the upper part of the nasal cavity and caused the brain-eating infection called granulomatous amoebic encephalitis (GAE).
Researchers are also "limited in our understanding" Keenan Piper, a member of the Swedish team that created the study. Among the factors that increase the likelihood of contracting the disease, including a weakened immune system, genetics and environmental factors, freshwater may be the cause.
Amoebas are found in freshwater sources around Puget Sound like wells, but not in the city's treated water, according to Liz Coleman, a spokeswoman for the Department of Environmental Public Health of the State Department of Health. The researchers were unable to test the woman's tap water, but according to Cobbs, one can not simply become infected by swallowing amoeba-contaminated water.
After the woman had contracted the amoebas, she got a red sore nose. For about a year, the wound was misdiagnosed and treated as a common, treatable skin condition known as rosacea, the study said. Cobbs said this was probably the first symptom of the amoeba, but its rarity makes it difficult to quickly diagnose the amoeba.
"It's an incredibly uncommon illness that it was not on someone else's radar that this initial nasal pain is related to their brain," Piper said.
The woman's infection is the first to be associated with inappropriate nasal rinsing, Piper said. Although the risk of infection to the brain is extremely low, people using Neti pots or other nasal irrigators can almost eliminate them by following the instructions on their devices, including using salt water or sterilized water, Maree said.
Three Amoebas types have caused fatal brain infections, according to Jennifer Cope, an epidemiologist at the Department of Disease Control and Prevention focused on food-borne illness and disease.
While infections are still rare, the Seattle woman died of the least known of all: Balamuthia mandrillaris. This is an amoeba species that moves more slowly and can take weeks or months to cause death. The other slow-acting amoeba is called Acanthamoeba spp.
Naegleria fowleri is the most documented, Cope said, because it works fast and causes an infection that leads to death within a few days. New Jersey health authorities have linked N. Fowleri to the death of one man in October. It was thought that he had become infected while surfing in a water park in Texas. According to Marek, N. fowleri is present in the waters of Puget Sound and other freshwater springs. Other local infection cases were not immediately known to her.
Cope said . All three types of amoebae have similar prevalence rates, however, Balamuthia mandrillaris is the least recognized medical community is rarely documented and offers limited research opportunities.
It is believed that the amoebae are primarily ground-based, but the "exact niche of the environment is really unknown," Cope said in an e-mail.
"As far as I'm concerned, it's everywhere – there are molds and fungi that can kill you if they infect your brain – MRSA (a treatable bacterial infection) is everywhere, but we have no mechanism for them It's always going to be a tough fight because people learn from things that happen over and over again, but I do not think there will be more cases in the future, at least I do not hope so. "