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Won, Kim, Kim, Oh, Ki, Han, Lee, and Kim: Disseminated Scedosporium apiospermum Infection Induced from Aspiration Pneumonia after Near-Drowning
Case Report
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2010; 69(4): 298-302.

Published online: 31 October 2010

DOI: https://doi.org/10.4046/trd.2010.69.4.298

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

Hoyoun Won, M.D.1, 2, Hyung Rae Kim, M.D.1, 2, Dong Hwan Kim, M.D.1, Jaewon Oh, M.D.1, 2, Jung Hye Ki, M.D.3, Chang Hun Han, M.D.1, Sun Min Lee, M.D.1, Cheong Ju Kim, M.D.1

1Department of Internal Medicine, National Health Insurance Corporation Ilsan Hospital, Goyang, Korea.

2Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.

3Department of Pathology, National Health Insurance Corporation Ilsan Hospital, Goyang, Korea.

Address for correspondence: Cheong Ju Kim, M.D. Department of Internal Medicine, National Health Insurance Corporation Ilsan Hospital, 1232, Baekseok-dong, Ilsan dong-gu, Goyang 410-719, Korea. Phone: 82-31-900-0237, Fax: 82-31-900-0343, kom2d@naver.com

Received 15 June 2010       Accepted 15 September 2010

Copyright © 2010. The Korean Academy of Tuberculosis and Respiratory Diseases. All rights reserved.

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.

Keywords: Scedosporium, Pneumonia, Aspiration, Near Drowning

Figures and Tables

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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