Two cases of severe pneumonia after the 2011 Great East Japan Earthquake

Abstract

In 2011, during the Great East Japan Earthquake and tsunami, 90% of victims died from drowning. We report on two tsunami survivors with severe pneumonia potentially caused by Legionella pneumophila. Both victims aspirated a large quantity of contaminated water; sand, mud and a variety of microbes were thought to have entered into their lower respiratory tracts. One patient had a mycotic intracranial aneurysm; the other patient had co-infections with several organisms, including Scedosporium species. Although scedosporiosis is a relatively rare infectious disease, symptoms are progressive and prognosis is poor. These pathogens are not specific for tsunami lung, but are reported causative agents for pneumonia after near-drowning.

Fig. 1

33-year-old woman’s chest X-ray showed alveolar infiltrate with air bronchogram in left upper lobe, and showed multifocal, bilateral nodular opacities

Fig. 2

Two-year-old girl’s chest X-ray showed right upper lobe consolidation and infiltrative shadow in left upper lobe

Fig. 3

Computed tomography scan of the brain after convulsion shows bleeding around brainstem associated with subarachnoid haemorrhage and hydrocephalus