Pneumonia Associated with Near‐Drowning

Abstract

Drowning and near-drowning can abruptly devastate the lives of both the affected victims and their families. In addition to the complications directly caused by the submersion, several indirect causes of morbidity exist. Infection is one of the complications associated with near-drowning, and pneumonia is the most severe of these infectious complications. The risk factors, microbiological causes, diagnostic approach, and appropriate therapy for pneumonia associated with near-drowning are not well described in the literature. Herein, we review the epidemiology and pathophysiology associated with near-drowning, discuss the potential mechanisms of infection, and describe the likely risk factors for pneumonia related to near-drowning. We also detail the microbiological causes of this entity and provide important clinical and epidemiological information associated with specific pathogens. Finally, we summarize an appropriate diagnostic and therapeutic approach to pneumonia associated with near-drowning.

Physicochemical Factors Affecting the Growth of Burkholderia pseudomallei in Soil Microcosm

“…3 Melioidosis patients were reported to be infected by inhalation [4][5][6][7] or percutaneous inoculation from contaminated muddy soil or stagnant water in endemic location, resulting in pneumonia [8][9][10] and sepsis, and up to 40% of treated patients died with this infection. 2,11,12 In Thailand, presence of B. pseudomallei in soil is the highest in the northeast.…”

Rapidly Progressive Pneumonia Due to Aeromonas hydrophila Shortly after Near-drowning.

“…Of these organisms, A. hydrophila is the most frequently reported bacillus to cause pneumoniaafter near-drowningand this type of pneumonia is the most serious (4). A. hydrophila is a facultative anaerobic gram-negative bacillus that is ubiquitous and commonly found in both freshwater and saltwater (4,6,7). It has been regarded as an opportunistic agent that causes sepsis, soft tissue infection, and gastroenteritis in immunologically compromised hosts (7).…”

“…Although cerebral hypoxia directly caused by submersion has been recognized as a major cause of death (2,3), mortality and morbidity attributable to infections have not been demonstrated. Only a few cases of pneumonia have been reported as a complication of near-drowning, however, pneumonia is one of the most life-threatening infections and its mortality reaches 60% (4). Wepresent a case of fulminant pneumonia caused by Aeromonashydrophila shortly after neardrowning and discuss the importance of prophylactic antibiotic therapy after near-drowning.…”

Tracking the Emerging Human PathogenPseudallescheria boydiiby Using Highly Specific Monoclonal Antibodies

“…The fungus is the most prevalent species after Aspergillus fumigatus in the lungs of cystic fibrosis patients (8), where it causes allergic bronchopulmonary disease (5) and chronic lung lesions simulating aspergillosis (24). Near-drowning incidents and recent natural disasters, such as the Indonesian tsunami in 2004, have shown P. boydii and the related species Scedosporium apiospermum and Scedosporium aurantiacum to be the causes of fatal central nervous system infections and pneumonia in immunocompetent victims who have aspirated polluted water (4,11,12,21,22,25,30,33,57). Its significance as a potential pathogen of disaster evacuees has led to its recent inclusion in the Centers for Disease Control and Prevention list of infectious etiologies in persons with altered mental statuses, central nervous system syndromes, or respiratory illness.…”