The woman, doctors realized, had been infected with Balamuthia mandrillaris, a type of amoeba that can infect the brain and cause massive damage.
Her case is reported this week in the International Journal of Infectious Diseases.
"The pathologist was able to look at it under a microscope and see the characteristic, actually the amoeba, in the tissue", said Dr. Charles Cobbs, Swedish Neuroscience Institute.More news: Greenland's ice is melting at an 'unprecedented rate'
The contaminated water went up the woman's nose "toward [the] olfactory nerves in the upper part of her nasal cavity", The Seattle Times reported, which ultimately caused the infection which first appeared as a red sore on her nose.
Doctors took the woman into critical care and quickly sent word to the Centers for Disease Control and Prevention, which rushed a shipment of an anti-amoeba drug called miltefosine. Since then, more than 200 cases have been diagnosed worldwide, with at least 70 cases in the USA, the CDC says. "It was just dead brain tissue", he tells Live Science. "At this point, the family made a decision to withdraw support", the report continued.
Most cases of brain-eating amoebas have been found in places like California, Arizona and Texas but Dr. Cobbs did say that over time, because of climate change, the amoeba could learn to survive in cooler areas like in Washington state.More news: AP top player Murray adds O’Brien; Tua wins Camp
Neti pots are used to pour saline into one nostril and out of the other to irrigate the sinuses, usually to fight allergies or infections.
"She had not been boiling water, using sterile water or using sterile saline".
Health officials suggest using only distilled, sterile or previously boiled water to rinse sinuses. But then Hopkins pathologists came back with a verdict: The infection looked "amoebic", said Cobbs, who thought, "that's ridiculous", upon hearing the news.
In the case report, the doctors said there was evidence of amoeba infection from neti pots before, but that they did not test the water their patients had been using, and so they could not be sure.More news: Alex Smith Battling Infection From Surgery on Broken Tibia, Fibula
What happened: The woman had been filling her neti pot with unfiltered water and using it to try to clear up a sinus infection.
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