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I accidentally let some tap water go up my nose an hour ago.

I am in Texas. I...
I accidentally let some tap water go up my nose an hour ago. I am in Texas. I fear getting N. fowleri amoebas into my brain where they will cause fatal infection and eat the brain. Is it too late to do something about it? I am very afraid, yet this still seems too premature to go to a clinic or ER for.
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Answered in 4 minutes by:
3/21/2018
Dr Josh
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Dr. Ravoof
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Dear customer,
Thank you for the question.Are you suffering from health related anxiety? Do you also worry about other possible diseases?Thank you!
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Customer reply replied 3 months ago
I do worry about such things. However, this one is specific, and I think more realistic, because I have read about people dying from tapwater going into their noses when using Neti pots to clear their sinuses. I was not using a Neti pot, however, water did still go from the tap into my nose anyway, and I worry about potential amoeba infection this way.
Dr. A
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Hi, it's Dr. A, the ENT physician. I will try to help you today.

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I can say that in my 6 years of seeing patients, almost all of them with nose issues, I have never seen anyone getting a brain infection from letting tap water in their nose. I also work with rhinologists who have over 30 years of experience treating only nasal/sinus issues and they have never seen this occur.

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Customer reply replied 3 months ago
Thanks for the reply.OK, but tap water going into the nose would be a rare occurrence anyway. I had read about the naegleri fowleri amoeba and how it is present primarily in the South, with a lot of the cases coming from Texas. I am in Austin, Texas. This was tap water directly from the tap - how long can it survive in the nose surface if the amoeba were present? 3 days?

They would survive less than three days. You would already have symptoms of lethargy, mental status changes, severe headaches, mucus drainage, etc. The incidents of those infections occurred with a neti pot, which is a high pressure delivery system that forces water into the top of the nose where the bacteria can get in. Simply inhaling the tap water would not provide enough force for this to occur. In addition, you would already have symptoms. Hope that helps.

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Customer reply replied 3 months ago
But sources said it could take up to 15 days for symptoms to appearhttps://en.wikipedia.org/wiki/Naegleriasis

Interesting. Thanks for the source. Sounds like symptoms can appear up to 9 days after exposure. For that reason, I would just be vigilant of symptoms. However, do realize that this is exceedingly rare, EVEN with the use of a netipot.

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Customer reply replied 3 months ago
OK, do the amoeba just not "take hold" most of the time, even when amoeba-laden water goes into the sinuses?Should I take a sample of home tap water somewhere for testing in a lab?also, if symptoms appear, is there still time for medical treatment to be useful?

Yes that's right.

No, I think that would be too much at this point. But if that would give you peace of mind, then go for it.

Yes, if symptoms appear there is still time for medical treatment. Fever, mental status change, lethargy, nausea, vomiting, headache would all be signs to look out for.

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Please let me know if you have any other questions. I would greatly appreciate it if you could give me a 5-star rating. We can continue to speak even after you rate if you would like. Thanks!

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Customer reply replied 3 months ago
Some follow-up questions:1. Why do the amoebas survive only three days inside the nose? Is it that the mucus lining or body internal lining is inhospitable to it, or because of white blood cells?2. If symptoms have already appeared, does that mean the human patient's survival rate has already fallen to, say, 30%?
Customer reply replied 3 months ago
Also, is it correct that the amoebas are only dangerous if they enter the sphemoid or ethmoid sinuses, but not the maxillary or frontal sinuses?
Customer reply replied 3 months ago
for clarification, I did not inhale the water - the water went up my nose because I had my face facing upwards and the tap water stream hit my nose and went directly in.

1. It is both of those things. The lining has some defense mechanisms to flush out the amoebas and the white blood cells can also fight off anything that gets into the lining.

2. It depends what symptoms. Mental status changes, lethargy could portend a poorer prognosis (ie maybe 30%). If it's caught when its only a headache then chances of survival are higher.

3. They are most dangerous when they enter the sphenoid. However, the other sinuses can also potentially be dangerous as they are also close to the eyes, and in the case of the frontal sinus, the brain.

4. OK.

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