Individuals who survive
near drowning often suffer from complicated
infections, including multi-organ and polymicrobial events. This pattern may be especially pronounced among patients exposed to infectious agents during catastrophic events like that of the Great East Japan Earthquake and the associated tsunami disaster. We report here on a patient who presented with Escherichia coli (E. coli)
pneumonia in combination with fungal
sinusitis and
meningitis. A 73-year-old woman survived the tsunami that engulfed the Sanriku coast. By the time of hospital admission, the patient exhibited high
fever, severe
cough, and sputum production. Chest X-ray and CT scan showed consolidation in the left upper lobe. Administration of an
antibacterial agent improved this
pneumonia. However, the patient's consciousness was increasingly impaired. Brain CT showed the low-density lesions and partial high-density spot in the sinus, which suggests the
fungal infection. MRI showed the
inflammation in the sinus spread into the central nerve system. The examination of the cerebrospinal fluid showed the low
glucose level, high mononuclear cell count, and highβ-
D glucan level, the findings of which supported the diagnosis of
fungal meningitis. Although the patient improved temporarily in response to combination treatment with
anti-fungal agents, no further improvement was seen. In conclusion, this patient, who suffered from
infections of
pneumonia,
sinusitis, and
meningitis, presented a quite rare clinical progress. We propose that
fungal infection should be taken into consideration in individuals who suffered
near drowning, a profile expected to be frequent among tsunami survivors.