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Prolonged Brackish Water Exposure: A Case Report.

Scott B Hughey1, Kari L McCoy2, Aaron E Mills2

  • 1Naval Medical Center Portsmouth, Portsmouth, Virginia.

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Summary

Long-term brackish water exposure can cause severe hypernatremia and hypothermia. Prompt treatment of these metabolic issues and associated infections is crucial for patient recovery.

Keywords:
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Area of Science:

  • Environmental Health
  • Toxicology
  • Infectious Diseases

Background:

  • Brackish water exposure poses risks including infection, hypernatremia, and hypothermia.
  • Limited data exist on managing long-term brackish water exposure complications.

Observation:

  • A case study of a 55-year-old male with 5-10 days of brackish water exposure.
  • The patient presented with severe hypernatremia (176 mEq·L⁻¹), hypothermia (34.5°C), and hypotension (88/50 mm Hg).
  • Complications included pneumonia with Vibrio parahemolyticus, Klebsiella oxytoca, and Shewanella algae, and skin pustules with Aeromonas hydrophilia and Aeromonas caviae.

Findings:

  • The patient ingested sand and gravel, requiring nasogastric removal.
  • Treatment involved antibiotics and intravenous fluids to correct metabolic derangements.
  • The patient recovered fully within 3 weeks.

Implications:

  • Brackish water exposure presents unique infectious and metabolic challenges.
  • Initial management should prioritize correcting hypovolemia, hypernatremia, and hypothermia.
  • Antibiotic selection should target likely causative organisms based on exposure history.