First it was an angry red rash on her nose that wouldn’t go away. Then it was a seizure. Then the numbness began on her left side.
The 69-year-old Seattle woman had gone to her doctor for help with a nagging sinus infection and had been told to flush out her nasal cavities with water using a device sometimes called a neti pot, according to a case report in the International Journal of Infectious Diseases.
But the problems never went away. They got worse and worse over a year, until she had a seizure — and doctors discovered the amoebas chewing away at her brain.
“When I operated on this lady, a section of her brain about the size of a golf ball was bloody mush,” Dr. Charles Cobbs said, according to 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.”
The woman, doctors realized, had been infected with Balamuthia mandrillaris, a type of amoeba that can infect the brain and cause massive damage.
“This is extremely rare. This amoeba was not even known 20 years ago hardly. There’s been about 200 cases world-wide,” Cobbs said, according to Q13 News.
Another type of brain-eating amoeba, commonly found in warm water and more generally known to doctors and the public, is called Naegleria fowleri. It can kill within days, not months, according to the Seattle Times.
Doctors took the woman into critical care and quickly sent word to the Centers for Disease Control and Prevention, which rushed a shipment of an anti-amoeba drug called miltefosine. Doctors gave her the medicine (and a cocktail of other anti-infection drugs), but she continued to get worse, according to the report. Within a week, she was in a coma, and her family decided to take her off life support.
But how did the amoebas get in her brain in the first place?
Brain-eating amoeba infections usually occur when water is forced up the nose, according to the CDC, particularly “when people go swimming or diving in warm freshwater places, like lakes and rivers.” It can happen in other places, too — one case in Texas might have been contracted at a surf resort, McClatchy previously reported.
In this case, doctors pointed to the neti pot the woman had been using to clear up her sinuses.
“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,” Cobbs said, according to KIRO.
In the case report, the doctors said there was evidence of amoeba infection from neti pots before, but that they did not test the water their patients had been using, and so they could not be sure.
“If you do use a neti pot ... you should be very aware that it has to be absolute sterile water or sterile saline,” Cobbs said, according to Q13 News.