@article{ref1,
title="Central nervous system pseudallescheriasis after near-drowning",
journal="Clinical neurology and neurosurgery",
year="2006",
author="Panichpisal, Kessarin and Nugent, Kenneth and Sarria, Juan C.",
volume="108",
number="4",
pages="348-352",
abstract="BACKGROUND: Clinical characteristics of central nervous system (CNS) pseudallescheriasis after near-drowning have not been systematically analyzed. METHODS: Review of cases reported in the English-language literature. RESULTS: Sixteen patients were identified. The average period between the near-drowning episode and onset of clinical manifestations was 37 days. Common manifestations included fever, altered mental status, headache, seizures, and hemiparesis. All patients developed brain abscesses; however, imaging studies were normal at presentation in 6 patients. Cerebrospinal fluid neutrophilic pleocytosis, elevated protein, and decreased glucose were commonly observed. Most patients were treated with surgical resection and systemic amphotericin B or miconazole. Voriconazole was used in 2 patients. Twelve patients (75%) died. The average time between the near-drowning episode and death was 12 weeks. Four survivors received prompt treatment. CONCLUSIONS: CNS pseudallescheriasis after near-drowning is highly lethal. Early diagnosis and aggressive medical and surgical interventions may improve survival.<p /><p>Language: en</p>",
language="en",
issn="0303-8467",
doi="10.1016/j.clineuro.2005.10.013",
url="http://dx.doi.org/10.1016/j.clineuro.2005.10.013"
}