Adult ; Extracorporeal Membrane Oxygenation ; methods ; Female ; Humans ; Near Drowning ; complications ; diagnostic imaging ; therapy ; Neuroimaging ; Treatment Outcome

Antifungal Agents ; therapeutic use ; Humans ; Male ; Mycoses ; diagnosis ; drug therapy ; Near Drowning ; microbiology ; Scedosporium ; pathogenicity

Acute kidney injury (AKI) secondary to near-drowning is rarely described and poorly understood. Only few cases of severe isolated AKI resulting from near-drowning exist in the literature. We report a case of near-drowning who developed to isolated AKI due to acute tubular necrosis (ATN) requiring dialysis. A 21-yr-old man who recovered from near-drowning in freshwater 3 days earlier was admitted to our hospital with anuria and elevated level of serum creatinine. He needed five sessions of hemodialysis and then renal function recovered spontaneously. Renal biopsy confirmed ATN. We review the existing literature on near-drowning-induced AKI and discuss the possible pathogenesis.
Acute Kidney Injury/*diagnosis/*etiology ; Anuria/etiology ; Creatinine/blood ; Humans ; Kidney Tubular Necrosis, Acute/etiology/pathology ; Male ; Near Drowning/*complications ; Renal Dialysis ; Young Adult

Scedosporium apiospermum, an asexual form of Pseudallescheria boydii, is a saprophytic mold with a worldwide distribution. It may cause severe pulmonary or disseminated infections in immunocompromised patients who have undergone organ transplantation, have hematological malignancies, or have received corticosteroid therapy. However, in immunocompetent patients, it usually produces localized infection and has been reported to cause pneumonia after near-drowning in polluted water. We present here the case of an immunocompetent 72-year-old woman with pneumonia caused by S. apiospermum.
Aged ; Female ; Fungi ; Hematologic Neoplasms ; Humans ; Immunocompromised Host ; Near Drowning ; Organ Transplantation ; Pneumonia ; Pseudallescheria ; Scedosporium ; Transplants

Drowning is the third leading cause of unintentional accidental death globally. The most serious pathophysiologic consequence of drowning is hypoxemia from acute respiratory distress syndrome. Herein, we report a drowning victim who presented with hypothermia and cardiac arrest, followed by acute respiratory distress syndrome, rhabdomyolysis (with acute kidney injury), and disseminated intravascular coagulopathy. Aided by advanced cardiac life support and mechanical ventilation in a prone position, the patient fully recovered after two days of hospitalization. Recovery was largely attributed to early prone ventilatory positioning and use of nitric oxide gas.
Adult ; Advanced Cardiac Life Support ; Anoxia ; Drowning ; Heart Arrest ; Hospitalization ; Humans ; Hypothermia ; Kidney ; Near Drowning ; Nitric Oxide ; Prone Position ; Respiration, Artificial ; Respiratory Distress Syndrome, Adult ; Rhabdomyolysis ; Ventilators, Mechanical

Scedosporium apiospermum, the anamorph of Pseudallescheria boydii, is a ubiquitous saprophytic fungus. S. apiospermum can cause life-threatening infections usually in immunocompromised patients or after near-drowning incidents. Here, we report the first case of disseminated infection caused by S. apiospermum after near-drowning in Korea. A 44-year-old healthy man developed aspiration pneumonia, followed by multiple brain abscesses, and endopthalmitis, after a near-drowning incident in a septic tank. S. apiospermum infection was diagnosed on the 33rd day after the incident had occurred. The patient died from the progressive renal failure 255 days after incident, although he had been treated with voriconazole.
Adult ; Brain Abscess ; Fungi ; Humans ; Immunocompromised Host ; Korea ; Near Drowning ; Pneumonia, Aspiration ; Pseudallescheria ; Pyrimidines ; Renal Insufficiency ; Scedosporium ; Triazoles

BACKGROUND: Extracorporeal membrane oxygenation (ECMO) during severe acute respiratory failure helps to recover the pulmonary function. This study evaluated our experience with veno-venous ECMO in adult patients with acute respiratory failure. METHODS: From January 2007 to July 2009, ECMO was used on 54 patients. Of these 54 patients, 7 were placed on veno-venous ECMO for acute respiratory failure. The indications of ECMO were based on the lung dysfunction measured as a PaO2/FiO2 ratio <100 mm Hg on FiO2 of 1.0, or an arterial blood gas pH <7.25 due to hypercapnia despite the optimal treatment. EBS(R), Bio-pump(R), and Centrifugal Rotaflow pump(R) were used and all cannulations were performed percutaneously via both femoral veins. When the lung function was improved, an attempt was made to wean on ECMO at moderate ventilator settings followed by decannulation. RESULTS: Five of the 7 patients were male and the mean age was 46.3+/-18.3. The causes of acute respiratory failure were 3 cases of pneumonia, 2 near-drownings, 1 pulmonary hemorrhage due to acute hepatic failure and 1 mercury vapor poisoning. The mean support time of ECMO was 17.3+/-13.7 days. Of the 7 patients implanted with ECMO, 5 patients (71%) were weaned off ECMO and 3 patients (43%) survived to hospital discharge after a mean 89.6 hospital days. CONCLUSION: The early use of ECMO for acute respiratory failure in adults due to any cause is a good therapeutic option for those unresponsive to the optimal conventional treatments.
Adult ; Catheterization ; Extracorporeal Membrane Oxygenation ; Femoral Vein ; Hemorrhage ; Humans ; Hydrogen-Ion Concentration ; Hypercapnia ; Liver Failure, Acute ; Lung ; Male ; Near Drowning ; Pneumonia ; Respiratory Distress Syndrome, Adult ; Respiratory Insufficiency ; Ventilators, Mechanical

Acute renal failure (ARF) secondary to immersion and near-drowning has rarely been described and it is poorly understood. ARF associated with immersion and near-drowning might be involved with systemic tissue hypoxia, hypovolemia and hypothermia. Some reports have shown that rhabdomyolysis could be involved. We report here on a 52 year old seaman who developed ARF after cold sea-water immersion. He had been swimming for one hour in cold sea-water because his ship became stuck on a rock. After 2 days, his serum creatinine level was increased to 7.8 mg/dL, and pulmonary edema was developed. The serum myoglobin level was 495.1 ng/mL. He was diagnosed as oliguric ARF and treated with hemodialysis. Thereafter, renal function was gradually recovered. We presumed that hypothermia-induced vasoconstriction, hypovolemia and rhabdomyolysis were involved in ARF in the patient. It should be considered that cold sea-water immersion for a long time could evoke ARF in healthy men.
Acute Kidney Injury ; Anoxia ; Cold Temperature ; Creatinine ; Humans ; Hypothermia ; Hypovolemia ; Immersion ; Male ; Myoglobin ; Near Drowning ; Pulmonary Edema ; Renal Dialysis ; Rhabdomyolysis ; Seawater ; Ships ; Swimming ; Vasoconstriction

Extracorporeal membrane oxygenation (ECMO) during acute respiratory failure due to any cause aids in the recovery of respiratory function. The use of ECMO for acute respiratory failure due to near drowning was reported to be a successful therapeutic option in those patients who do not respond to optimal conventional therapies. We performed veno-venous ECMO for 2 acute respiratory failures due to near-drownings. All cannulations were performed percutaneously via both femoral veins. The 2 patients were successfully weaned off ECMO, but one patient experienced diffuse hypoxic brain damage and a subarachnoid hemorrhage.
Cardiopulmonary Bypass ; Catheterization ; Extracorporeal Membrane Oxygenation ; Femoral Vein ; Humans ; Hypoxia, Brain ; Near Drowning ; Respiratory Distress Syndrome, Adult ; Respiratory Insufficiency ; Subarachnoid Hemorrhage

Children are in their course of growth and development, and this is the most important feature in understanding childhood injuries, which is somewhat different from those in adults. Injury is different from accident in that the latter cannot be expected and prevented, and also different from trauma that means the external forces on the body and the response against the force. Injury can be expected scientifically and prevented. The risk of injuries in children is closely related to the age, sex, socio-economical status, and environment. Injuries are always the most common cause of death in children throughout the world, and traffic accident is the most common cause of childhood injuries. Burn, near drowning, and fall down occupy most of the causes of injuries in infancy, and pedestrian injuries and traffic accidents are the major causes of injuries in pre-school ages. Suicide becomes an important cause of injuries in adolescents. Sexual abuse should be considered seriously in children with perineal injuries without definite causes. All of these childhood injuries are closely related to the status of growth and development of children.
Accidents, Traffic ; Adolescent ; Adult ; Burns ; Cause of Death ; Child ; Growth and Development ; Humans ; Near Drowning ; Sex Offenses ; Suicide