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- W2078956040 abstract "To the Editor.—We read with great interest the report and exhaustive review of Leroy et al,1 who described a fatal case of invasive pulmonary and cerebral aspergillosis after a near-drowning episode in a child.We recently described 2 cases of Scedosporium apiospermum cerebral abscess and spondylodiscitis in adult tsunami survivors after near-drowning episodes.2 In the case described by Leroy et al, the patient developed the cerebral fungal infection only a few days after the accident. On the contrary, our patients presented neurologic and back-pain symptoms several weeks after the accident. The culture of the cerebral guided computed tomography biopsy and the cultures of the bone biopsy yielded S apiospermum infections, which confirmed the infection in the 2 different body sites.We would like to stress that those rare but well-described fungal infections associated with near-drowning events could manifest themselves after a temporary gap of several weeks. Furthermore, they can be silent or present only mild and nonspecific symptoms for weeks. Infections caused by S apiospermum or Aspergillosis spp. carry a high mortality rate, up to 90% in the case of central nervous system infections.3 A close follow-up, therefore, is mandatory for several weeks after the episode, and a close monitoring of the neurologic disorders should be kept. The risk is higher in situations where a big inoculum of stagnant, dirty—or, worst, muddy or drain-contaminated—water is inhaled or extensive soft tissues injuries are present. Very rapid and aggressive diagnostic procedures are mandatory to avoid delay in therapy instauration. Microbiology research will focus also on the possibility of the presence of less frequent microorganisms.4 Given the long list of possible pathogens, empirical antifungal therapy with voriconazole combined with lipid formulation of amphotericin B should be started in suspected molds infection after near-drowning events while waiting for definite microbiologic results." @default.
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- W2078956040 date "2007-02-01" @default.
- W2078956040 modified "2023-10-16" @default.
- W2078956040 title "Long-term Risk of Atypical Fungal Infection After Near-Drowning Episodes" @default.
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- W2078956040 doi "https://doi.org/10.1542/peds.2006-2954" @default.
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