一名近乎溺水患者发生的致命肺部感染：病例报告
Fatal pulmonary infection in a patient after near-drowning: A case report.
作者信息
Ghasemian Roya, Bandegani Azadeh, Kermani Firoozeh, Faeli Leila, Roohi Behrad, Yousefi-Abdolmaleki Elham, T Hedayati Mohammad, Roilides Emmanuel, Shokohi Tahereh
机构信息
Antimicrobial Resistance Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran.
Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran.
出版信息
Curr Med Mycol. 2021 Dec;7(4):38-42. doi: 10.18502/cmm.7.4.8410.
BACKGROUND AND PURPOSE
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 species associated with a car crash and near-drowning in a sewage canal. isolated from bronchoalveolar lavage was identified by PCR-sequencing of 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 spp., and early initiation of appropriate antifungal therapy.
背景与目的
拟青霉属真菌是一种腐生真菌，在免疫抑制和免疫功能正常的宿主中，可能因吸入受污染的水而导致侵袭性肺部感染。
病例报告
在此，我们报告一例由与车祸及在污水渠中近乎溺水相关的拟青霉属真菌感染导致的致命性肺部感染病例。通过对基因进行聚合酶链反应测序，鉴定出从支气管肺泡灌洗中分离出的拟青霉属真菌。两性霉素B、伊曲康唑、泊沙康唑、艾沙康唑的最低抑菌浓度值>16μg/ml，阿尼芬净、米卡芬净和卡泊芬净的最低抑菌浓度值>8μg/ml。伏立康唑被发现是活性最强的药物，最低抑菌浓度为1μg/ml。
结论
本报告作为伊朗近乎溺水后发生肺部拟青霉病的首例病例，凸显了对近乎溺水受害者高度怀疑、及时鉴定拟青霉属真菌以及尽早开始适当抗真菌治疗的重要性。
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