amphotericin-b and Near-Drowning

Many victims of the tsunami that occurred following the Great East Japan Earthquake on March 11, 2011 developed systemic disorders owing to aspiration pneumonia. Herein, we report a case of tsunami lung wherein Scedosporium aurantiacum was detected in the respiratory tract. A magnetic resonance image of the patient's head confirmed multiple brain abscesses and lateral right ventricle enlargement. In this case report, we describe a potential refractory multidrug-resistant infection following a tsunami disaster.

Topics: Aged; Amphotericin B; Antifungal Agents; Brain Abscess; Central Nervous System Fungal Infections; Delayed Diagnosis; Female; Humans; Japan; Lung Diseases, Fungal; Magnetic Resonance Imaging; Near Drowning; Pyrimidines; Scedosporium; Survivors; Tomography, X-Ray Computed; Triazoles; Tsunamis; Voriconazole

This article reports on a previously healthy 17-month-old boy who developed pulmonary mucormycosis after a near-drowning incident in a goose pond. The patient survived without neurological sequelae and recovered, under treatment with amphotericin B, from the rare and often invasive fungal infection with Rhizopus spp., usually occurring in immunodeficient patients.

Topics: Amphotericin B; Antifungal Agents; Humans; Infant; Lung Diseases, Fungal; Male; Mucormycosis; Near Drowning; Rhizopus

Topics: Amphotericin B; Antifungal Agents; Drug Therapy, Combination; Fatal Outcome; Humans; Invasive Pulmonary Aspergillosis; Male; Middle Aged; Near Drowning; Shock, Septic; Voriconazole

Pseudallescheria boydii is a ubiquitously occurring fungus. While rarely causing opportunistic infection in humans, it is the most common cause of fungal pneumonia in cases of near drowning, and is associated with high mortality. P. boydii typically causes cutaneous mycetomas but may invade the lungs or brain. P. boydii infections are difficult to treat due to amphotericin B resistance and frequent need for surgical resection. Zygomycetous infections, often referred to as "mucormycoses," usually occur in immunocompromised hosts, trauma or burn victims. Like P. boydii, these organisms are found on decaying vegetation and in soil. Zygomycetous infections generally require debridement and prolonged amphotericin B. We report a case of P. boydii pneumonia with a simultaneous brain lesion and cutaneous mucormycosis in a near drowning patient. The pneumonia responded to treatment with voriconazole and the brain lesion resolved without surgery. The cutaneous mucormycosis responded to surgery and amphotericin B. This is the first documented case of simultaneous invasive P. boydii and cutaneous mucormycosis successfully treated with dual systemic antifungal therapy and resection.

Topics: Accidents, Traffic; Adult; Amphotericin B; Anti-Infective Agents; Ciprofloxacin; Dermatomycoses; Humans; Lung Diseases, Fungal; Magnetic Resonance Imaging; Male; Near Drowning; Pseudallescheria; Tomography, X-Ray Computed; Zygomycosis