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Fatal Balamuthia mandrillaris brain infection associated with improper nasal lavage

Keenan J Piper1, Haidn Foster2, Daniel Susanto3

  • 1Swedish Medical Group, 550 17th Avenue Suite 540, Seattle, WA 98122, USA.

International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases
|September 24, 2018
PubMed

Insights

Improper nasal irrigation led to a fatal Balamuthia mandrillaris brain infection in a 69-year-old female. This case highlights the risks of Balamuthia infections from contaminated water sources.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Dermatology

Background:

  • Nasal irrigation is a common practice for sinus issues.
  • Improper use of nasal irrigation can introduce contaminants.
  • Opportunistic infections can arise from contaminated water sources.

Observation:

  • A 69-year-old female developed a chronic nasal skin rash.
  • She presented with new-onset focal seizures.
  • A cerebral ring-enhancing lesion was identified on imaging.

Findings:

  • The patient's symptoms followed a year of improper nasal irrigation.
  • Diagnosis confirmed a brain infection caused by Balamuthia mandrillaris.
  • Despite aggressive anti-amoebic treatment, the infection was fatal.

Implications:

  • This case underscores the critical importance of sterile techniques in nasal irrigation.
  • Balamuthia mandrillaris poses a significant risk for severe neurological infections.
  • Public health awareness regarding safe nasal irrigation practices is crucial.
Keywords:
AmoebaAmoebic encephalitisBalamuthia mandrillarisInfectious encephalitisNasal lavage

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