{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T04:18:15Z","timestamp":1787804295735,"version":"build-2784847793"},"reference-count":5,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T00:00:00Z","timestamp":1787702400000},"content-version":"vor","delay-in-days":25,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82560320"],"award-info":[{"award-number":["82560320"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Respirology Case Reports"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Early pulmonary abnormalities after freshwater drowning can be overinterpreted as bacterial pneumonia, especially when inflammatory biomarkers and respiratory microbiology are positive. A 20\u2010year\u2010old man was resuscitated after approximately 2\u2009min of freshwater submersion. Day 1 chest CT showed bilateral lower\u2010lobe\u2010predominant opacities compatible with non\u2010cardiogenic pulmonary oedema and aspiration\u2010related lung injury, with near\u2010complete resolution by Day 25. Day 3 bronchoscopy showed diffuse, non\u2010removable, millet\u2010seed\u2010like whitish tracheal mucosal protrusions with hyperaemia and oedema, compatible with acute irritative airway injury. BALF mNGS detected multiple gram\u2010negative bacterial signals, predominantly\n                    <jats:styled-content style=\"fixed-case\">\n                      <jats:italic>Klebsiella pneumoniae<\/jats:italic>\n                    <\/jats:styled-content>\n                    , while sputum culture yielded ESBL\u2010negative, susceptible\n                    <jats:styled-content style=\"fixed-case\">\n                      <jats:italic>K. pneumoniae<\/jats:italic>\n                    <\/jats:styled-content>\n                    . Possible drowning\u2010associated pneumonia was considered because of aspiration, fever, markedly elevated inflammatory biomarkers and concordant microbiology; however, rapid radiological improvement and clinical stability suggested a substantial non\u2010infectious component. The patient recovered after an 8\u2010day course of piperacillin\u2013tazobactam without antibiotic escalation, corticosteroids, mechanical ventilation or acute respiratory distress syndrome.\n                  <\/jats:p>","DOI":"10.1002\/rcr2.70731","type":"journal-article","created":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T10:52:57Z","timestamp":1787741577000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pulmonary Infiltrates, Airway Mucosal Lesions and Respiratory Microbiology After Freshwater Drowning: A Case Report"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0612-797X","authenticated-orcid":false,"given":"Huan","family":"Xiao","sequence":"first","affiliation":[{"name":"Department of Emergency The First Affiliated Hospital of Guangxi Medical University  Nanning China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu\u2010Xi","family":"Rao","sequence":"additional","affiliation":[{"name":"Department of Emergency The First Affiliated Hospital of Guangxi Medical University  Nanning China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mei\u2010Li","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Emergency The First Affiliated Hospital of Guangxi Medical University  Nanning China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3941-4860","authenticated-orcid":false,"given":"Wei","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Emergency The First Affiliated Hospital of Guangxi Medical University  Nanning China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chao\u2010Qian","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Emergency The First Affiliated Hospital of Guangxi Medical University  Nanning China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,26]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/10806032241227460"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13054\u2010021\u201003687\u20102"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13613\u2010024\u201001287\u20101"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciy693"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev\u2010pathmechdis\u2010012418\u2010012751"}],"container-title":["Respirology Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/rcr2.70731","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/rcr2.70731","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/rcr2.70731","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T03:23:18Z","timestamp":1787800998000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/rcr2.70731"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8]]},"references-count":5,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1002\/rcr2.70731"],"URL":"https:\/\/doi.org\/10.1002\/rcr2.70731","archive":["Portico"],"relation":{},"ISSN":["2051-3380","2051-3380"],"issn-type":[{"value":"2051-3380","type":"print"},{"value":"2051-3380","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8]]},"assertion":[{"value":"2026-06-29","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-11","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-26","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70731"}}