title: Pneumonia involving Aspergillus and Rhizopus spp. after a near-drowning incident with subsequent Nocardia cyriacigeorgici and N. farcinica coinfection as a late complication.
abstract: Reported here is the case of a 22-year-old man who developed pneumonia with unusual pathogens after a near-drowning incident. On day 7 following admission, Rhizopus spp. and Aspergillus fumigatus were cultured from the patient's bronchoalveolar lavage fluid. One week later, sputum cultures revealed N. cyriacigeorgici as well as N. farcinica. The patient recovered fully after prolonged therapy with liposomal amphotericin B, amikacin, meropenem and cotrimoxazole.
authors.affiliation: Clinical Microbiology Laboratory, Leiden University Medical Centre, P.O. Box 9600, 2300 RC Leiden, The Netherlands. a.van_dam@lumc.nl
authors.forename: A P
authors.initials: AP
authors.lastname: van Dam
authors.forename: M T C
authors.initials: MT
authors.lastname: Pruijm
authors.forename: B I J
authors.initials: BI
authors.lastname: Harinck
authors.forename: L B S
authors.initials: LB
authors.lastname: Gelinck
authors.forename: E J
authors.initials: EJ
authors.lastname: Kuijper
mesh_terms: D000328:Adult; D000935:Antifungal Agents / Q000627:therapeutic use; D001228:Aspergillosis / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D001232:Aspergillus fumigatus / Q000302:isolation & purification*; D004359:Drug Therapy, Combination; D005500:Follow-Up Studies; D016469:Fungemia / Q000175:diagnosis* / Q000188:drug therapy; D006801:Humans; D008172:Lung Diseases, Fungal / Q000175:diagnosis* / Q000188:drug therapy; D008297:Male; D009091:Mucormycosis / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D015701:Near Drowning; D009615:Nocardia / Q000145:classification* / Q000302:isolation & purification; D009617:Nocardia Infections / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D012233:Rhizopus / Q000302:isolation & purification*; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D000935:Antifungal Agents