ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2012
Primary amebic meningoencephalitis deaths associated with sinus irrigation using contaminated tap water.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 76 papers, 2 of them syntheses that pooled it.
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Who cites it
76 citing papers in PubMed, 2 syntheses or guidelines pooled it, 173 citations in OpenAlex.
- Fatal brain infection in early life: primary amoebic meningoencephalitis caused by Naegleria fowleri in neonates and infants.BMC infectious diseases · 2026Pooled it
- Clinical Practice Guideline: Nasal Irrigation for Chronic Rhinosinusitis in Adults.Clinical and experimental otorhinolaryngology · 2022Guideline
- Global Review onInfectious disease reports · 2026Review
- Detection ofACS ES&T water · 2026Article
- Article
- Notes from the Field: Primary Amebic Meningoencephalitis Associated with Nasal Irrigation Using Water from a Recreational Vehicle - Texas, 2024.MMWR. Morbidity and mortality weekly report · 2025Article
- Cryptic presentation: primary amoebic meningoencephalitis mimicking a high-grade malignancy resulting in surgical fatality within 48 hours. Illustrative case.Journal of neurosurgery. Case lessons · 2025Article
- Review
- Exploring cotton plant compounds for novel treatments against brain-eating Naegleria fowleri: An In-silico approach.PloS one · 2025Article
- Pharmacophore Establishment and Optimization of Saturated 1,6-Naphthyridine-Fused Quinazolinones that Inhibit Meningoencephalitis-CausingJournal of medicinal chemistry · 2024Article
- Microplastics in the Olfactory Bulb of the Human Brain.JAMA network open · 2024Article
- Acanthamoeba Infection and Nasal Rinsing, United States, 1994-2022.Emerging infectious diseases · 2024Article
- Noninvasive diagnostic biomarkers, genomic profiling, and advanced microscopic imaging in the early detection and characterization ofAnnals of medicine and surgery (2012) · 2024Review
- Nanoparticle-Terpene Fusion: A Game-Changer in Combating Primary Amoebic Meningoencephalitis Caused byACS omega · 2024Article
- A Case of Primary Amebic Meningoencephalitis Associated with Surfing at an Artificial Surf Venue: Environmental Investigation.ACS ES&T water · 2023Article
- Microbial Characterization, Factors Contributing to Contamination, and Household Use of Cistern Water, U.S. Virgin Islands.ACS ES&T water · 2022Article
- Distribution and Current State of Molecular Genetic Characterization in Pathogenic Free-Living Amoebae.Pathogens (Basel, Switzerland) · 2022Review
- Differential Growth Rates andMicrobiology spectrum · 2022Article
- The therapeutic potential of novel isobenzofuranones against Naegleria fowleri.International journal for parasitology. Drugs and drug resistance · 2021Article
- Comparative Genomic and Transcriptomic Analysis of Naegleria fowleri Clinical and Environmental Isolates.mSphere · 2021Article
16 more citing papers are in PubMed but not listed here.
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Authors and funding
21 authors at 7 institutions in 1 country.
Funding
Abstract
backgroundNaegleria fowleri is a climate-sensitive, thermophilic ameba found in the environment, including warm, freshwater lakes and rivers. Primary amebic meningoencephalitis (PAM), which is almost universally fatal, occurs when N. fowleri-containing water enters the nose, typically during swimming, and N. fowleri migrates to the brain via the olfactory nerve. In 2011, 2 adults died in Louisiana hospitals of infectious meningoencephalitis after brief illnesses.
methodsClinical and environmental testing and case investigations were initiated to determine the cause of death and to identify the exposures.
resultsBoth patients had diagnoses of PAM. Their only reported water exposures were tap water used for household activities, including regular sinus irrigation with neti pots. Water samples, tap swab samples, and neti pots were collected from both households and tested; N. fowleri were identified in water samples from both homes.
conclusionsThese are the first reported PAM cases in the United States associated with the presence of N. fowleri in household plumbing served by treated municipal water supplies and the first reports of PAM potentially associated with the use of a nasal irrigation device. These cases occurred in the context of an expanding geographic range for PAM beyond southern tier states with recent case reports from Minnesota, Kansas, and Virginia. These infections introduce an additional consideration for physicians recommending nasal irrigation and demonstrate the importance of using appropriate water (distilled, boiled, filtered) for nasal irrigation. Furthermore, the changing epidemiology of PAM highlights the importance of raising awareness about this disease among physicians treating persons showing meningitislike symptoms.
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