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

Yutaka Nakamura, Yu Utsumi, Naomi Suzuki, Yoshio Nakajima, Okinori Murata, Nobuhito Sasaki, Hiroo Nitanai, Hiromi Nagashima, Shinya Miyamoto, Jun Yaegashi, Tomoki Hatakeyama, Yoshihiro Shibano, Kyoko Yarita, Katsuhiko Kamei, Toshihide Nakadate, Shigeatsu Endo, Yasuo Terayama, Kohei Yamauchi

Research output: Contribution to journalArticle

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Abstract

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.

Original languageEnglish
Article number526
JournalJournal of Medical Case Reports
Volume5
DOIs
Publication statusPublished - 2011 Oct 27
Externally publishedYes

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Scedosporium
Tsunamis
Abscess
Survivors
Japan
Near Drowning
Lung Abscess
Brain Abscess
Magnetic Resonance Spectroscopy
Thorax
Infection
Tomography
Ventricular Premature Complexes
Fluid Therapy
Bronchoalveolar Lavage Fluid
Aspergillus
Therapeutics
Drug-Related Side Effects and Adverse Reactions
Voriconazole
Brain

ASJC Scopus subject areas

  • Medicine(all)

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Multiple Scedosporium apiospermum abscesses in a woman survivor of a tsunami in northeastern Japan : A case report. / Nakamura, Yutaka; Utsumi, Yu; Suzuki, Naomi; Nakajima, Yoshio; Murata, Okinori; Sasaki, Nobuhito; Nitanai, Hiroo; Nagashima, Hiromi; Miyamoto, Shinya; Yaegashi, Jun; Hatakeyama, Tomoki; Shibano, Yoshihiro; Yarita, Kyoko; Kamei, Katsuhiko; Nakadate, Toshihide; Endo, Shigeatsu; Terayama, Yasuo; Yamauchi, Kohei.

In: Journal of Medical Case Reports, Vol. 5, 526, 27.10.2011.

Research output: Contribution to journalArticle

Nakamura, Y, Utsumi, Y, Suzuki, N, Nakajima, Y, Murata, O, Sasaki, N, Nitanai, H, Nagashima, H, Miyamoto, S, Yaegashi, J, Hatakeyama, T, Shibano, Y, Yarita, K, Kamei, K, Nakadate, T, Endo, S, Terayama, Y & Yamauchi, K 2011, 'Multiple Scedosporium apiospermum abscesses in a woman survivor of a tsunami in northeastern Japan: A case report', Journal of Medical Case Reports, vol. 5, 526. https://doi.org/10.1186/1752-1947-5-526
Nakamura, Yutaka ; Utsumi, Yu ; Suzuki, Naomi ; Nakajima, Yoshio ; Murata, Okinori ; Sasaki, Nobuhito ; Nitanai, Hiroo ; Nagashima, Hiromi ; Miyamoto, Shinya ; Yaegashi, Jun ; Hatakeyama, Tomoki ; Shibano, Yoshihiro ; Yarita, Kyoko ; Kamei, Katsuhiko ; Nakadate, Toshihide ; Endo, Shigeatsu ; Terayama, Yasuo ; Yamauchi, Kohei. / Multiple Scedosporium apiospermum abscesses in a woman survivor of a tsunami in northeastern Japan : A case report. In: Journal of Medical Case Reports. 2011 ; Vol. 5.
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abstract = "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.",
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T2 - A case report

AU - Nakamura, Yutaka

AU - Utsumi, Yu

AU - Suzuki, Naomi

AU - Nakajima, Yoshio

AU - Murata, Okinori

AU - Sasaki, Nobuhito

AU - Nitanai, Hiroo

AU - Nagashima, Hiromi

AU - Miyamoto, Shinya

AU - Yaegashi, Jun

AU - Hatakeyama, Tomoki

AU - Shibano, Yoshihiro

AU - Yarita, Kyoko

AU - Kamei, Katsuhiko

AU - Nakadate, Toshihide

AU - Endo, Shigeatsu

AU - Terayama, Yasuo

AU - Yamauchi, Kohei

PY - 2011/10/27

Y1 - 2011/10/27

N2 - 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.

AB - 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.

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