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Journal of Clinical Pathology 2004;57:202-204; doi:10.1136/jcp.2003.010066
Copyright © 2004 by the BMJ Publishing Group Ltd & Association of Clinical Pathologists.
Journal of Clinical Pathology 2004;57:202-204
© 2004 BMJ Publishing Group Ltd & Association of Clinical Pathologists

SHORT REPORT

Central nervous system Aspergillus fumigatus infection after near drowning

P A Kowacs1, S Monteiro de Almeida1,3, R L Pinheiro3, H Fameli1, E J Piovesan1, A Correia2 and L C Werneck1

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:
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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This article has been cited by other articles:

  • Leroy, P., Smismans, A. (2007). Long-term Risk of Atypical Fungal Infection After Near-Drowning Episodes: In Reply. Pediatrics 119: 417-418 [Full Text]  
  • Leroy, P., Smismans, A., Seute, T. (2006). Invasive Pulmonary and Central Nervous System Aspergillosis After Near-Drowning of a Child: Case Report and Review of the Literature. Pediatrics 118: e509-e513 [Abstract] [Full Text]  
  • Kowacs, P A, Soares Silvado, C E, Monteiro de Almeida, S, Ramos, M, Abrao, K, Madaloso, L E, Pinheiro, R L, Werneck, L C (2004). Infection of the CNS by Scedosporium apiospermum after near drowning. Report of a fatal case and analysis of its confounding factors. J. Clin. Pathol. 57: 205-207 [Abstract] [Full Text]  

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