Neti pots are effective ways to clear sinuses and alleviate some of the symptoms of allergies, but the misuse of one lead to the death of a 69-year-old Seattle woman.

Upon the advice of her primary physician a Seattle woman used a Neti pot to treat her chronic sinus infection, but for months she used tap water instead of distilled or sterilized water.

Unknown to her at the time, and to the bafflement of her doctors, a rare brain-eating amoeba likely traveled from her bloodstream to her brain causing seizures and ultimately her death.

“Frankly, it was the last thing I had in my mind when I went in to operate on what I thought was a typical brain tumor,” said neurosurgeon Dr. Charles Cobbs.

It wasn’t until pathology came back from the biopsy, they discovered the real culprit of her symptoms: balamuthia mandrillaeis. Balamuthia mandrillaeis is a rare amoeba found in soil and possibly in tap water and diagnosed in only 200 cases worldwide.

“When I operated…a section of her brain…was bloody mush,” Dr. Cobbs relayed. By the time doctors understood what was happening, it was too late. The woman passed away a few weeks after her diagnosis and biopsy.

Despite the woman using a Brita water filter to fill the Neti pot, she still contracted the organism. Only sterile or distilled water should be used in Neti pots or infections, and in rare cases like this, organisms can become a problem.

While it may be too late for this woman, doctors hope sharing this warning will save lives. Neti pots are great tools to combat seasonal ailments, but only when used correctly. Pray for the family of this woman and follow the advice of both doctors and manufacturers’ when using medical devices.