Background and purpose: Scedosporium spp. is a saprophytic fungus that may cause invasive pulmonary infection due to the aspiration of contaminated water in both immunosuppressed and immunocompetent hosts.
Case report: Herein, we report a fatal case of pulmonary infection caused by Scedosporium species associated with a car crash and near-drowning in a sewage canal. Scedosporium aurantiacum isolated from bronchoalveolar lavage was identified by PCR-sequencing of β-tubulin genes. The minimum inhibitory concentration values for amphotericin B, itraconazole, posaconazole, isavuconazole were >16 µg/ml, and >8 µg/ml for anidulafungin, micafungin, and caspofungin. Voriconazole was found to be the most active agent with a MIC of 1 µg/ml.
Conclusion: This report, as the first case of pulmonary scedosporiosis after near-drowning in Iran, highlights the importance of high suspicion in near-drowning victims, prompt identification of Scedosporium spp., and early initiation of appropriate antifungal therapy.
Keywords: Amphotericin B; Antifungal susceptibility test; Invasive pulmonary infection; Near-drowning; Scedosporium aurantiacum; Voriconazole.
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