title: An elusive diagnosis: Scedosporium apiospermum infection after near-drowning.
abstract: A 51-year-old male was admitted in our institute following an episode of near-drowning. He later developed ventriculitis and cerebral ring-enhancing lesions. He died following a subarachnoid hemorrhage due to rupture of a mycotic aneurysm involving the right fetal posterior cerebral artery. Scedosporium apiospermum was isolated from the cerebrospinal fluid. Central nervous system invasion by S apiospermum may present insidiously in near-drowning patients and, therefore, requires a high index of suspicion. In cases with the characteristic cerebral ring-enhancing lesions and concomitant ventriculitis, treatment should be instituted while awaiting fungal culture. With this article we intend to alert neurologists, intensivists, and physicians to this near fatal infection, as early identification and prompt treatment with voriconazole may be life saving.
authors.affiliation: Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India.
authors.forename: Malini
authors.initials: M
authors.lastname: Gopinath
authors.forename: Ajith
authors.initials: A
authors.lastname: Cherian
authors.forename: Neeraj N
authors.initials: NN
authors.lastname: Baheti
authors.forename: Abhijit
authors.initials: A
authors.lastname: Das
authors.forename: Molly
authors.initials: M
authors.lastname: Antony
authors.forename: C
authors.initials: C
authors.lastname: Sarada