The death of a 47-year-old man in the US Virgin Islands from primary amebic meningoencephalitis demonstrates the risk of infection with Naegleria fowleri from nasal cleansing with a neti pot or similar device.
The man had used tap water for daily household tasks and for ablution, a ritual cleansing in Islamic prayer that includes nasal rinsing. N fowleri, a free-living ameba found in warm freshwater, enters the nose and migrates to the brain. Investigators found the organism in the shower and hot water heater of the man’s home, suggesting that it had colonized the plumbing system.
Risks of Nasal Rinsing. JAMA. 2014;311(4):351. doi:10.1001/jama.2013.285359