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3/12/2018
Onlinedoc
Onlinedoc, Doctor
Category: Medical
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Experience: General physician with experience in General & Family Medicine,Ayurveda, Integrative, CAM
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Customer reply replied 4 months ago
ok so heres the deal i was washing my face with hot tap water and some got in my nostril it didnt shoot all the way up but it got in im worried i have contracted naegleria fowleri from the tap water 2 days since it happend i know have bad bad nausea and am really panicking i dont think there has every been a case in new york city so im worried doctors wont believe me

Sorry for late reply and inconvenience.
Thanks for the follow-up.
I understand your concern.
As per your description, It's very very rare rather I should say extremely rare to get it from tap water. It is found in outdoor lakes and ponds.

I can give you an assurance that you are safe.

You can take OTC Pepcid and Liquid Emetrol for nausea.

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Dr Subbanna MD
Dr Subbanna MD, Neurologist (MD)
Category: Medical
Satisfied Customers: 6,340
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Hi, I am an American Board Certified Neurologist with vast experience in diagnosing & treating all neurological as well as all other health/medical conditions. I see you have asked for a new professional, and I am very glad to help you with your health concerns.

I see some water had accidentally entered your nostril during washing your face and subsequently you have been having bad nausea and now you are concerned about the possibility having been infected with naegleria fowleri ameba. As a Neurologist I am very familiar with this type of health situation, and I can certainly help you in this regard.

Please see, it is certainly unlikely you have contracted naegleria fowleri infection during this incident you have described above

This is because the water did not reach the upper part of the nose

The ameba can enter the brain only if it reaches the upper part of the nose

Many people get some water in to their nostrils during bathing or washing the face etc, if this is sufficient to contract this amebic infection then so many people would have got infected with this infection

This amebic infection occurs only when the water reaches the upper part of the nose from where there are connections to the brain through certain nerve fibers

If water just enters your nose then it not dangerous, ameba cannot reach the upper part of the nose from inside the nostril region

In your case the water has just entered the nostrils like it happens with most of the people all the time when they bathe or when the wash their face etc, so it is unlikely ameba can reach upper region of the nose

Also this amebic infection should present with severe headache, neck stiffness, altered sensorium etc just nausea alone is not a symptom of this condition

But even if you have headaches, neck stiffness or altered sensorium etc still you are unlikely to have contracted this infection because water entering the nostrils is a normal phenomenon that happens quite frequently

People who dive in to water or those who accidentally snort water in to the upper part of the nose, or who lavage of their sinus etc with un-boiled tap water are the ones who may develop this infection

Even if water reaches the upper part of the nose still most individuals do not develop this infection because there are multiple other factors that need to be met or fulfilled before someone can actually get infected with this ameba

There are so many people who do diving in to swimming pools, or other water bodies and so many people accidentally let some water enter their upper part of the nose but this infection is so rare, only around 140 cases have been identified with this condition for the whole USA since around 1960s, so you can see how rare this infection is

But since water entered only to your nostril area and it did not shoot up all the way up the nose so you are certainly safe here

Once again I can very confidently reassure you, there is definitely no possibility of you having contracted naegleria fowleri amebic infection during the incident you have mentioned above, and there is not even an iota of suspicion for this amebic infection in you, if nausea persists then this needs further evaluation but it is certainly unlikely secondary to naegleria fowleri infection since you have definitely not contracted this infection, so please not to be scared.

Wishing you the best health!

All the very best!

Please let me know if you have any additional questions or if you want to discuss this further. And please take a moment and kindly click a positive rating (preferably 5 Star/Excellent) to credit for the time & effort put by me in answering your health question, and this is the only way I will be credited for my service to you. Rating me now does not close your question and if you have follow-up or additional questions you can ask them after the rating too!

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Dr Subbanna MD

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Customer reply replied 4 months ago
ok doctor thank you your answer was great and well detailed so just splashing the water in my face should not concern me as i it has to reach around the part of the top of the eye is that correct? as i said i dont think there has ever been a case in NYC so im trying to put that in my mind to calm me down

You are very welcome! Yes precisely, water has to enter the upper part of the nose and only from the upper part of the nose there is connection to the brain but not from the nostril area etc. Through olfactory nerve fibers (nerve for the smell sensation) that are present only in the upper part of the nose this ameba enters the brain, so if some water enters the nostril area there is absolutely no possibility of contracting naegleria fowleri infection, and accordingly you are totally safe in this regard.

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Customer reply replied 4 months ago
I’m just worried what if I splashed to hard or snorted some up after is it possible to splash your face hard enough to where if reaches the upper canal portion of your nose I know most people wash there face and never think of this but it’s stressing me out really bad

It is really unlikely water can reach like that to the upper region of the nose. This may happen when someone dives in to a water body from a height, or does lavage of the sinus etc using devices such as netipot but otherwise there is no possibility of water reaching the upper part of the nose during the activities you have mentioned above. For water to reach the upper part lot of force need to be generated and it is unlikely during washing face etc – even if you splashed water hard etc any water can reach the upper aspects of the nose.

You are 100% safe! Absolutely no possibility of having contracted naegleria fowleri infection during the incident you have mentioned above!

Please take a moment and kindly click a positive rating (preferably 5 Star/Excellent) to credit for the time & effort put by me in answering your health question, and this is the only way I will be credited for my service to you. Rating me now does not close your question and if you have follow-up or additional questions you can ask them after the rating too!

Assuring you the best services!

Wishing you all the very best!

Best Regards!

Dr Subbanna MD

Dr Subbanna MD
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Customer reply replied 4 months ago
I can only find 3 cases from Louisiana that were associated with tap water so it seems pretty rare most jump in lakes and streams in the south but my mind is still telling me that I’ll be the 1st person in NYC to get it from tap water

Yes, the tap water causing this amebic infection is almost unknown except some stray cases such as the ones you have mentioned above. And for water to reach the upper regions of the nasal cavity water has to enter the nose with really high pressure, and such force or pressure is unlikely to be generated during washing face etc, even if you splash the water hard against the nose region, and as you have also put is correctly water may reach the upper region of the nasal cavity if someone jumps in to lakes and streams etc or in to the swimming pools that are not chlorinated.

In your case there is absolutely no risk of having contracted naegleria fowleri infection, it is just the health anxiety & fear of serious illnesses are getting the better of you, you have remained 100% safe in this regard during the incident you had mentioned earlier.

Wishing you all the very best!

Thanks & Best Regards!

Dr Subbanna MD

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I also wanted to add this to my previous note, the extremely rare cases of these few amebic infections occurred after tap water use must have been secondary to some unusual way they handled their tap water, and I do not think they contracted this infection just during washing their face etc, even if they had splashed the water hard against their face & nostril region. For example the tap water may have been used for neti pot nasal & sinus lavage where copious amounts of water reaches the upper region of the nasal cavity. Or there might have been some other similar situations where there was actual reaching of large amount of water in to the upper regions of the nasal cavity and this might have resulted in this infection. Because if washing the face as you have done can be the cause - then that is how most of the people wash their face, so they must have used the tap water for something more than just for washing their face resulting in water actually reaching the risky upper region of the nasal cavity.

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Customer reply replied 4 months ago
No I believe it was from Neti pots and riding down a slip and slide but as you have said there has never been a case in New York
Customer reply replied 4 months ago
That’s what I’m trying to believe even though I’m still worried the nausea is caused from the water but I have no headaches yet

You have not contracted naegleria fowleri infection for sure.

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Customer reply replied 4 months ago
Hello doc apparently I have no luck whatsoever I now have what I feel like is a cold sore throat and stuffy runny nose starting with a ton of sneezeing this morning but now I read this can be from the naegleria Fowleri should I go to the hospital or can it just be a cold i don’t know what to do anymore plus the nausea has gone away at least

Hello, while I see you have been having some additional symptoms now but there is definitely no suspicion for naegleria fowleri infection in you. If someone is having this infection then it will cause excruciatingly severe headache, serve vomiting, neck stiffness, reduced level of consciousness, confusion, disorientation, passing out, seizures etc and these types of symptoms are must to start suspecting this infection. And nausea has gone away also tells this infection is unlikely. The new symptoms you have been experiencing are definitely not due to naegleria fowleri infection and for ruling out this amebic infection there is absolutely no need to go to hospital, and your new symptoms must be from cold or allergy etc.

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Customer reply replied 4 months ago
My mother did recently have a cold but I rarely ever get sick like maybe once a year sometimes not even once but of course it would come out now it all started with sneezing very frequently then woke up with the sore throat and stuffy nose then hoped on google and seen sore throat and runny nose were signs of naeglaria now I’m back at square one
Customer reply replied 4 months ago
I have none of the symptoms that you mentioned yet

Naeleria fowleri causes meningoencephalitis (infection of the brain and brain covering called as meninges), and when these structures are affected symptoms such as excruciatingly severe headache, vomiting, neck stiffness, reduced level of consciousness, confusion, passing out etc are all must – even at the earliest stage these symptoms are certainly going to be present, since you are not having these symptoms so you have not contracted this infection. And water too certainly had not reached the upper region of the nasal cavity in your case, so to start with you were never having any risk during this incident.

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Customer reply replied 4 months ago
Well doc I have had a really bad day I have a 99.7 oral temp and sore throat and bad sinus problems I’m pretty sure I may have sucked the water up through my nose and I have the naeglaria infection I said I had bad luck now it appears I’m going to be the first one in New York to get this no less from tap water my mom had a bad cold but I don’t remember her having any fevers

This is such a mild temp at 99.7, and also no other symptoms that I had mentioned earlier. You have not sucked water up through your nose and you are not going to be the first naegleria fowleri infection case in New York because you have not contracted this amebic infection at all.

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Customer reply replied 4 months ago
Tylenol seems to normalize my temp for a while after I take it but once it wears off I feel feverish again is this normal with a bad cold

Yes, bad cold can certainly do this.

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Customer reply replied 4 months ago
I went to the Er doc I’m currently here now since my temp went up 100.0 plus I developed dry heaving and nausea so I was just really stressed I hope that take me serious

The er dr will take medical history, examine you, and also arrange any labs as necessary, and I too hope they take your case seriously. But you are not having naegleria fowleri infection for sure.

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Customer reply replied 4 months ago
Also I took 2 pills from zpack can that cause dry heaving and nausea
Customer reply replied 4 months ago
I truly hope not but I feel so ill and it’s just so weird that it happened 4 days after the water incident I keep trying to tell myself my mother was sick but why would my cold be so much worse then hers

Zpack may do this, amebic infection unlikely.

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Customer reply replied 4 months ago
Hello doc so I went and my blood said I have high neurophil and low lymphocyte the doctor of course didn’t think I had the amoeba would an amoeba cause an immune response like this or could it be the cold causing this response

hello, yes these findings could be cold related, no amebic infection as expected.

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Customer reply replied 4 months ago
Is an amebic infection considered a bacterial infection and couldn’t that raise my neutrophil or can a cold raise neutrophils

Cold can explain these lab findings.

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Customer reply replied 4 months ago
Without the use of tylonol my fever continues to come back at what point should I go to the ER and demand a spinal tap

Only if severe headache occurs.

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Customer reply replied 4 months ago
Cause by now this has to be the naeglaria right I’ve tried everything it’s been 5 days now my fever is at 100.8

Certainly not naegleria.

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Customer reply replied 4 months ago
At this point what could it be I’ve tried everything to get better can a bacterial infection present just like a virus infection
Customer reply replied 4 months ago
What’s weird is at some moments I feel a million times better guessing when I take the tylonol but once it wears off I feel very sick again I’m worried my neutrophil were high cause of possible infection in the brain i just don’t know anymore but if it is naeglaria I more then Likely don’t have much time left anyway

For the current symptoms you need to contact your dr and find out whether they want to investigate further to find out the cause for these new symptoms, but this is certainly not due to naegelria.

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Customer reply replied 4 months ago
Why would tylonol work for 6 hours then the fever come right back my still running the 100.8 temputure which is worry me because my other symptoms don’t feel as bad makes me think what is going on as you know doc naeglaria is rare so it’s very hard to get people to take your concerns serious eschpeially when you haven’t been in water they don’t even acknowledge that tap water can cause it

You are definitely not a case of naegleria.

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Customer reply replied 4 months ago
I’m getting worse though today I had a fever of 101 that only went down to 99 with Tylenol

You need to see your dr or visit an urgent care clinic or er etc for this fever - if it is not resolving, but this is certainly not due to naegleria.

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Customer reply replied 4 months ago
I’m at the ER again the Tylenol worked again I went from 101 to 98.8 with the medication but in soon as 6 hours is up it will prob rise so I went to the ER going to try and request a spinal tap doc I just wanted to make you aware that I was using really war tap water when I splashed my face I don’t know how high the olfactory nerve is is it around the eyeballs or between them ? I heard warm tap water is even worse so I’m pretty sure that all this is from a naeglaria infection and by the time it’s found it will all be to late
Customer reply replied 4 months ago
I also wanted to mention when I was washing my face I felt something in my nostril like water went up it I just don’t know how high it’s suppose to get I didn’t feel burning or even cough from it but it felt like it went slightly up

Naegleria infection is impossible in you. Only the following circumstances can make an individual get infected with this ameba;

a) Jumping or diving in to the water of lakes, ponds, rivers, spring water/hot spring water, swimming holes or natural swimming pools etc – most cases occur after these incidents

b) Waterskiing, wakeboarding – very rare few cases

c) Baptism full immersion underwater (dunking) - one case

d) Jumping or diving in to swimming pool water – very rare few cases

e) Water used for recreational activities either at home back yard such as slip N slide or Kid’s Inflatable Play Center comprising of water slide + kiddie pool/wading pool etc, or water recreational activities at theme parks such as water slides etc – one or two cases

f) Using garden hose, sprinklers etc – very rare few cases

During all these above mentioned water activities or water incidents there is possibility water may enter the nose with so much force so that it may reach the upper part of nose (which corresponds to the region of nasal cavity at or above the eye level) - from where the ameba can enter the brain through olfactory nerve.

And two conditions need to be met with or fulfilled before this ameba can enter the brain - 1) Unchlorinated water is used, 2) Un-boiled water is used, 3) The water reached the upper region of the nose – as described just above

OR

g) Using Neti pot etc through which water (unchlorinated or un-boiled water) is made flow through the nose for nasal irrigation or lavage and this too brings copious amount of water into contact with the upper part of the nose – few rare cases have occurred, but again all these cases occurred when the water used was not properly chlorinated or un-boiled

OR

h) Using tap water – this is rarest of rare possibility (only couple of cases so far), and again the above 3 conditions need to be met of fulfilled, in otherwords whatever hard you splash tap water against your face it is unlikely to carry water to the upper region of the nose corresponding to the entry point through olfactory nerve, so the tap water causing this infection will occur only if tap water is used for c, d, e, f purposes that are mentioned earlier above - during which water may enter the risky region of upper nose, not enough if water enters just the nostrils or entry point of the nose, it should reach the upper risky region of the nose, so even in the worst case scenario of where the tap water you had used was not properly chlorinated (and of course it was not boiled water too) - but there is no way that water had entered the upper risky region of the nasal cavity - so it is impossible for you to have contracted this amebic infection during the incident you have mentioned earlier

In your case since the water has definitely not entered the risky upper region of the nasal cavity so you have not contracted naegleria infection for sure.

If you are still concerned then you can insist the er doctors for a spinal tap and csf analysis etc, but there is no way you are going to be diagnosed of naegleria fowleri infection for sure.

Once again reassuring you 100% no possibility of naegleria fowleri infection in you!

Wishing you all the very best!

Best Regards!

Dr Subbanna MD

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Customer reply replied 4 months ago
Thanks for your help doc you really went out of your way to help I hope your right

You are very welcome! I am very glad I could help!

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Customer reply replied 4 months ago
Just wondering if my 30 dollar payment went through if not can you sent another

Appreciate for trying to send the payment, but at my side it shows it has failed. If you have more questions or if you need further assistance in this regard please contact the company directly and they can help you in this regard.

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My daughter 19 yrs old has a head cold and now is suffering with ear ache in both ears. I have given her ear drops but thought that she may need antibiotics if its an infection. The problem is that sh… read more
Dr Su S
Dr Su S
Doctoral Degree
20,499 satisfied customers
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Disclaimer: Information in questions, answers, and other posts on this site ("Posts") comes from individual users, not JustAnswer; JustAnswer is not responsible for Posts. Posts are for general information, are not intended to substitute for informed professional advice (medical, legal, veterinary, financial, etc.), or to establish a professional-client relationship. The site and services are provided "as is" with no warranty or representations by JustAnswer regarding the qualifications of Experts. To see what credentials have been verified by a third-party service, please click on the "Verified" symbol in some Experts' profiles. JustAnswer is not intended or designed for EMERGENCY questions which should be directed immediately by telephone or in-person to qualified professionals.

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