For a therapy rooted in ancient ayurvedic medicine, it is perhaps not surprising that there have not been many startling developments regarding nasal irrigation for chronic rhinosinusitis. A slow but steady increase in popularity, a few seminal studies and a Cochrane review documenting its safety and efficacy were about all one could point to in the way of newsworthy trends.
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November 2012That all changed in February, when the Centers for Disease Control and Prevention in Atlanta announced that two patients had died from primary amebic meningoencephalitis (PAM) that had likely been caused by sinus irrigation with contaminated tap water. The culprit? Naegleria fowleri, a rare and usually lethal thermophilic amoeba that had colonized both patients’ household plumbing, according to the CDC and other infectious disease specialists, noted in a full report on the cases published online in August (Clin Infect Dis. DOI:10.1093/cid/cis626).
As a result of these cases, both the CDC and the FDA warned that only distilled, boiled or properly filtered water should be used when preparing saline solutions for nasal washes.