Nasal rinsing and tap water

Seven's On Call with Dr. Jay Adlersberg
March 27, 2008 3:55:09 PM PDT
It turns out that what many people do to breath easier could actually end up making things worse.Seven's On Call with Dr. Jay Adlersberg.

Sinus infections sometimes take a few weeks to clear up. But what if one hangs on for months at a time? A new report says doctors and patients should search for an infection caused by a germ that can live in tap water.

Bill Pearson gets IV treatments to boost his immune system. Before them, he got a whopping sinus infection that lasted three years.

"I did all kinds of antibiotic treatments through my [general practitioner] and other doctors," he said. "I even had sinus surgery to clean the nose out, which didn't help."

Bill had rinsed his sinuses with a salt water solution he made with tap water. That tap water may be linked to sinus infections with a germ called atypical mycobacterium, a first cousin of the tuberculosis germ.

Nurse practitioner Jennifer Walsh did the study.

"We found 24 patients with chronic sinusitis we think is due to this TB-like organism," she said.

Chlorine in tap water doesn't kill TB-like germs. Like tuberculosis, they can cause chronic infections, such as abscesses and bone infections. Besides water, the germs are also found in the soil. Unlike TB, these infections are not contagious.

It is not clear that sinus rinsings with tap water caused these infections, as the water in the homes of patients was not tested for atypical TB.

Sinus rinsing involves squirting salt water into one nostril, up into the sinuses and out the other side. Sinus rinses are commonly used by allergy patients to rinse out pollen from the nose.

All the study patients had rinsed their sinuses with tap water and salt, so infection from water is a possibility. Several special antibiotics cleared up Bill's TB-like infection.

Doctors say more studies need to be done on tap water-TB-like sinusitis connection.

"At this point, to be the safest, we are suggesting that patients use sterile saline water to irrigate their nose," Walsh said.

This is a very preliminary report, with many unanswered questions. Most sinus infections are caused by viruses and some by germs that are sensitive to standard antibiotics. But for an infection that don't get better for weeks, a patient might consider this very unusual infection and check with a doctor.