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Central nervous system Aspergillus fumigatus infection after near drowning

¹ Neurology Division, Internal Medicine Department, Hospital de Clínicas da Universidade Federal do Paraná, 80060-900, Curitiba, Brazil
² Neurosurgery Department, Hospital de Clínicas da Universidade Federal do Paraná
³ Clinical Analysis Laboratory, Hospital de Clínicas da Universidade Federal do Paraná

Correspondence to:
Dr P A Kowacs
Neurology Division, Internal Medicine Department, Hospital de Clínicas da Universidade Federal do Paraná, Rua General Carneiro 181, Sala 1236, 80060-900, Curitiba, Brazil; cefaleia{at}hc.ufpr.br
ABSTRACT
Aims: To report the case of a 26 year old white man, who developed chronic meningitis and intracerebral granulomata 15 days after an episode of near drowning in a swamp.

Methods: Aspergillus fumigatus was isolated from cerebrospinal fluid cultures.

Results: The patient died 70 days after the symptoms were first noticed, and seven days after a subarachnoid haemorrhage. Aspergillus has never been reported before as a cause of intracranial infection after near drowning. Conclusions: Physicians must be aware of this possibility when confronted with such a situation, because there are now effective therapeutic options for systemic aspergillosis.

Keywords: near drowning; Aspergillus sp; aspergillosis; brain abscess; meningitis

Abbreviations: ALT, alanine aminotransferase; AST, aspartate aminotransferase; CAT, computerised tomography; CNS, central nervous system; CSF, cerebrospinal fluid; IV, intravenous; b.i.d., twice a day; t.i.d., three times a day; q.i.d., four times a day; MRI, magnetic resonance imaging

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