Tuberc Respir Dis.  2010 Oct;69(4):298-302. 10.4046/trd.2010.69.4.298.

Disseminated Scedosporium apiospermum Infection Induced from Aspiration Pneumonia after Near-Drowning

• Won H
• Kim HR
• Kim DH
• Oh J
• Ki JH
• Han CH
• Lee SM
• Kim CJ

• KMID: 2114626
• DOI: http://doi.org/10.4046/trd.2010.69.4.298

Abstract

Scedosporium apiospermum, the anamorph of Pseudallescheria boydii, is a ubiquitous saprophytic fungus. S. apiospermum can cause life-threatening infections usually in immunocompromised patients or after near-drowning incidents. Here, we report the first case of disseminated infection caused by S. apiospermum after near-drowning in Korea. A 44-year-old healthy man developed aspiration pneumonia, followed by multiple brain abscesses, and endopthalmitis, after a near-drowning incident in a septic tank. S. apiospermum infection was diagnosed on the 33rd day after the incident had occurred. The patient died from the progressive renal failure 255 days after incident, although he had been treated with voriconazole.

Keyword

Scedosporium; Pneumonia, Aspiration; Near Drowning

MeSH Terms

Adult
Brain Abscess
Fungi
Humans
Immunocompromised Host
Korea
Near Drowning
Pneumonia, Aspiration
Pseudallescheria
Pyrimidines
Renal Insufficiency
Scedosporium
Triazoles
Pyrimidines
Triazoles

Figure

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  Figure 1 Chest PA showed (A) pneumonic consolidation at both lower lung fields and chest CT showed (B) parenchymal infiltrates through both lung fields on the admission. Chest PA showed (C) patch consolidation infiltration at both lung fields on 4 days after the admission.

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  Figure 2 Brain CT (A) obtained 33 days after the near-drowning accident and axial T2 weighted MR image (B) showed multiple hyperintense lesions with slightly hypointense rim with minimal surrounding edema.

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  Figure 3 On H&E staining of enucleated right eye, acute inflammatory exudate and stromal edema are seen (A, ×100) and on PAS stain, fungal hyphae are seen (B, ×400).

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  Figure 4 Gray colored colonies growing on Sabouraud dextrose agar after incubation for 14 days at 30℃.

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