Emptying the nasal cavity is a common method to cleanse the breasts, but it can also be a vector for the deadly amoeba that eats the brain. At least that is what can happen if you do not follow the instructions carefully, as a new case report made very clear.
Using a pout or other personal irrigation device helps many people to breathe more easily by washing and moistening their nasal passages, but the fatal experience of a Seattle woman highlights the potentially extreme risk of not using sterile water with these types of aids. Cheers. .
"When I operated this lady, a part of her brain the size of a golf ball was bloody porridge," said neurosurgeon Charles Cobbs of the Swedish Medical Center. The Seattle Times.
"There were these amoebas all over the place just eating brain cells. We had no idea what was going on, but when we got the tissue, we could see it was the amoeba."
About a year before that, the 69-year-old woman in question had developed chronic sinusitis.
When the medicine did not relieve her symptoms, her doctor suggested using a saline irrigation device to cleanse her breasts. These devices release the sinus system with a salt water solution that clears the nasal passage, but as the guidelines recommend, it is important to use only free water from any infectious organism.
That means using distilled or sterile water, or using boiled and cooled water that is boiling for 3 to 5 minutes. Aside from that, the pot or other device used should also be sterile, which means rubbing between uses.
Unfortunately, the 69-year-old woman, in this case, did not follow these instructions. Instead of using sterile water with the device, she cleaned her breasts with tap water that had not been boiled.
After a month of treatment, his sinus infection turned into a large rash on the bridge of the nose, along with a red, raw skin in the nasal opening.
Despite several visits to his dermatologist, the mystery behind these strange symptoms – initially suspected of being a rosacea – remained unresolved, although a sudden decline in his health a year later provided some answers.
About a year after the eruption of the nose appeared, the patient experienced a seizure, with the woman losing her cognition and her left side trembling.
A CT scan revealed what appeared to be a tumor the size of a small coin in the motor cortex on the right side of the brain. A biopsy showed necrosis consistent with such a tumor, but when the patient returned only a few days later with new symptoms, further analysis revealed that the lesions were scattered throughout the brain.
"On the 19th postoperative day, the consulting neuropathologist at Johns Hopkins University suggested the possibility of amoebic infection," the case note explains.
"Subsequent histopathological evaluation of the second resection revealed clear evidence of amebic infection and dramatic hemorrhagic necrosis."
While it is unclear how the woman contracted the amoeba infection, researchers suspect that the organism – Balamuthia mandrillaris – entered the woman's brain through "improper nasal wash," first entering her bloodstream, before settling at home in her brain.
What is not in doubt is that infections like this are very rare. In fact, if the team hypothesis is correct, it represents the first B. mandrillaris infection of the nasal lavage, although another type of amoeba – Naegleria fowleri – it was previously reported to infiltrate humans in this way.
"The pathologist was able to examine it under a microscope and see the characteristic, actually the amoeba, in the tissue," Cobbs told FOX Q13.
"This amoeba has not been known for 20 years, there are about 200 cases around the world."
Unfortunately, since the woman in the case had her culprit identified, it was too late. Despite aggressive anti-amoebic therapy, her condition worsened, and in a litter of more than a week she was dead.
While the rarity of these types of infections means we should not panic about them, researchers are also reminding people that if they use neti devices to cleanse their breasts, it is imperative to do so safely. , following all the guidelines.
"The reason you may have brain infections by nasal irrigation, as opposed to swallowing tap water or bathing under running water, is that the roof of the nose is one of the only parts of the human body where there is a direct extension of the brain" . and the central nervous system to the outside world, "Otolaryngologist Ben Bleier of Harvard Medical School, who was not involved in the case, said TIME.
"We still think it's very, very safe to use. You just have to do it in a clean way."
The results are reported in International Journal of Infectious Diseases.