Fatal pulmonary Scedosporium aurantiacum infection in a patient after near-drowning: A case report

Document Type : Case report

Authors

1 Antimicrobial Resistance Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran

2 Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran

3 Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran

4 Invasive Fungi Research Centre (IFRC), Mazandaran University of Medical Sciences, Sari, Iran

5 Department of Internal Medicine, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran

6 Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran

7 Infectious Diseases Section, 3rd Department of Pediatrics, Faculty of Medicine, Aristotle University School of Health Sciences, Thessaloniki, Greece

10.18502/cmm.7.4.8410

Abstract

Background and Purpose: Scedosporium spp. is a saprophytic fungus that may cause invasive pulmonary infection due to the aspiration of contaminated water in both immunosuppressed and immunocompetent hosts.
Case report: Herein, we report a fatal case of pulmonary infection caused by Scedosporium species associated with a car crash and near-drowning in a sewage canal.Scedosporium aurantiacum isolated from bronchoalveolar lavage was identified by PCR-sequencing of β-tubulin genes. The minimum inhibitory concentration values for amphotericin B, itraconazole, posaconazole, isavuconazole were >16 µg/ml, and >8 µg/ml for anidulafungin, micafungin, and caspofungin. Voriconazole was found to be the most active agent with a MIC of 1 µg/ml.
Conclusion: This report, as the first case of pulmonary scedosporiosis after near-drowning
in Iran, highlights the importance of high suspicion in near-drowning victims, prompt
identification of Scedosporium spp., and early initiation of appropriate antifungal therapy.
 

Keywords