Multiple Scedosporium apiospermum abscesses in a woman survivor of a tsunami in northeastern Japan: A case report

被引：28

作者：

Nakamura Y. ^{[1
]}

Utsumi Y. ^{[1
]}

Suzuki N. ^{[1
]}

Nakajima Y. ^{[1
]}

Murata O. ^{[1
]}

Sasaki N. ^{[1
]}

Nitanai H. ^{[1
]}

Nagashima H. ^{[2
]}

Miyamoto S. ^{[2
]}

Yaegashi J. ^{[3
]}

Hatakeyama T. ^{[3
]}

Shibano Y. ^{[3
]}

Yarita K. ^{[4
]}

Kamei K. ^{[4
]}

Nakadate T. ^{[5
]}

Endo S. ^{[5
]}

Terayama Y. ^{[6
]}

Yamauchi K. ^{[1
]}

机构：

[1] Division of Pulmonary Medicine, Allergy, and Rheumatology, Department of Internal Medicine, Iwate Medical University School of Medicine, Morioka, 0208505

[2] Department of Pulmonary Medicine, Iwate Prefectural Miyako Hospital, Miyako, 0270096

[3] Department of Internal Medicine, Saiseikai Iwaizumi Hospital, Iwaizumi aza, Iwaizumi town, Shimoheigun, 0270501

[4] Medical Mycology Research Center, Chiba University, Chiba, 2608673

[5] Department of Critical Care Medicine, Critical Care and Emergency Center, Iwate Medical University School of Medicine, Morioka, 0208505

[6] Division of Neurology and Gerontology, Department of Internal Medicine, Iwate Medical University School of Medicine, Morioka, 0208505

来源：

Journal of Medical Case Reports | / 5卷 / 1期

关键词：

Voriconazole; Brain Abscess; Micafungin; Liposomal Amphotericin; Sanriku Coast;

D O I：

10.1186/1752-1947-5-526

中图分类号：

学科分类号：

摘要：

Introduction. Scedosporium apiospermum is increasingly recognized as a cause of localized and disseminated mycotic infections in near-drowning victims. Case presentation. We report the case of a 59-year-old Japanese woman who was a survivor of a tsunami in northeastern Japan and who had lung and brain abscesses caused by S. apiospermum. Initially, an aspergillus infection was suspected, so she was treated with micafungin. However, computed tomography scans of her chest revealed lung abscesses, and magnetic resonance images demonstrated multiple abscesses in her brain. S. apiospermum was cultured from her bronchoalveolar lavage fluid, and antimycotic therapy with voriconazole was initiated. Since she developed an increase in the frequency of premature ventricular contractions, an adverse drug reaction to the voriconazole was suspected. She was started on a treatment of a combination of low-dose voriconazole and liposomal amphotericin B. After combination therapy, further computed tomography scans of the chest and magnetic resonance images of her brain showed a demarcation of abscesses. Conclusions: Voriconazole appeared to have a successful record in treating scedosporiosis after a near drowning but, owing to several adverse effects, may possibly not be recommended. Thus, a combination treatment of low-dose voriconazole and liposomal amphotericin B may be a safe and effective treatment for an S. apiospermum infection. Even though a diagnosis of scedosporiosis may be difficult, a fast and correct etiological diagnosis could improve the patient's chance of recovery in any case. © 2011Nakamura et al; licensee BioMed Central Ltd.

引用

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