MONDAY, Dec. 10, 2018 (HealthDay News) — The use of tap water in a nasal-flushing Neti pot likely led to a Seattle woman’s death from a Balamuthia mandrillaris brain infection, doctors write in a case study.

It is believed that instead of using sterile water or saline, the 69-year-old woman used tap water she had put in a filter-equipped pitcher, CBS News reported. The Balamuthia mandrillaris amoeba got into her upper nasal cavity and then into her bloodstream, eventually reaching her brain, according to the study published in the December issue of the International Journal of Infectious Diseases.

This rare case serves as a reminder for people to follow the directions when using a Neti pot and to use only boiled or distilled water, said Charles Cobbs, M.D., a neurosurgeon at the Swedish Medical Center in Seattle who treated the woman, CBS News reported. “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. “This is so rare there have only been like 200 cases ever.”

Swimming in warm freshwater lakes and rivers is the most common cause of such cases, but in rare instances, such infections occur after tap water gets into the nose, according to the U.S. Centers for Disease Control and Prevention.

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