A 71-year-old Texas woman tragically died after developing a rare brain infection from rinsing her sinuses using tap water in an RV’s onboard water system at a campground. Despite the water being safe to drink, it became lethal when introduced into her nasal passages. Symptoms emerged within four days, and she succumbed eight days after they began.
The Culprit: Naegleria fowleri
The infection was caused by Naegleria fowleri, a microscopic amoeba often called the “brain-eating amoeba.” Though commonly found in warm freshwater—like lakes, rivers, and hot springs—it can also thrive in untreated or stagnant tap water. Once the amoeba enters through the nose, it travels to the brain, causing primary amebic meningoencephalitis (PAM)—a fast-progressing and almost always true fatal infection.
Symptoms and Fatal Progression
After nasal exposure, initial signs—fever, headache, nausea, and vomiting—typically appear within 5–15 days. In this case, symptoms began on day four. Rapidly advancing symptoms included stiff neck, confusion, altered mental status, seizures, and coma. Despite medical intervention, the Texas patient died just eight days after symptom onset.
A Rare but Deadly Threat
Since 1962, the CDC has documented 157 confirmed U.S. cases through 2022
nypost.com. Cases predominantly occur in southern states like Texas and Florida, where warmer climates foster amoeba growth. The death rate for PAM is approximately 97%, with only four survivors ever recorded in the U.S.
Why Tap Water Isn’t Always Safe
Although municipal tap water is generally safe to drink, it isn’t sterile. For nasal irrigation, even harmless-sounding tap water can carry amoebas into the delicate nasal passages. The difference between drinking and nasal use is crucial: stomach acid neutralizes pathogens ingested orally, but water entering through the nose reaches sensitive tissues directly.
Broader Amoeba Risks
Aside from N. fowleri, other free-living amoebas like Acanthamoeba and Balamuthia mandrillaris have caused similarly dangerous infections—including skin, lung, eye, and brain infections resulting in granulomatous amebic encephalitis (GAE). The CDC reviewed 10 cases linked to nasal rinsing with tap water; seven recovered, but three died.
Safe Sinus Rinsing Practices
Health experts strongly advise using only one of the following:
- Distilled or sterile bottled water, or
- Boiled tap water (at least 1 minute; extend to 3 minutes if over 6,500 ft elevation), then cooled.
Additional precautions:
- If unboiled tap water must be used, use a filter certified to NSF 53, NSF 58, or with a pore size ≤1 micron.
- For freshwater activities (lakes, rivers, hot springs), avoid letting water go up your nose—hold it, use a nose clip, or keep your head above water.
- Regularly clean and dry nasal irrigation devices between uses.
- Visit a doctor immediately if you develop persistent headaches, fever, confusion, stiff neck, or seizures after nasal rinsing.
Takeaway Advice
While infections from brain-eating amoebas are extremely rare, they are brutally deadly. It’s vital to treat nasal rinsing with the same respect as surgical procedures—use properly sterilized water, keep devices clean, and flush sinuses safely. This Texas case is a tragic lesson: something as routine as real rinsing sinuses can turn lethal if proper water protocols aren’t observed.
