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(Pao2) and carbon dioxide (Paco2) tensions when he was breathing air were 6-7 and 3-6 kPa; the pH was 7-38. Intensive medical support, including assisted ventilation, was begun but his arterial blood gas tensions continued to deteriorate. After two hours of intensive medical aid he coughed up about 15 ml of bright red blood, became severely shocked, and despite intensive medical efforts died three hours after admission.At necropsy the lungs were heavy, the left lung weighing 790 g and the right 870 g. The right lung was uniformly and diffusely solid and the left lung had multiple confluent foci. Microscopically there was vascular engorgement and the alveoli were flooded with erythrocytes and mononuclear and granular leucocytes. Zones of necrosis and haemorrhage were present. Many small Gram negative bacilli were seen in both lungs, especially in the areas of necrosis. Other organs were normal apart from generalised congestion.An organism recovered from blood was cultured on a brain-heart infusion at 37°C after 24 hours and one from a necropsy sample of the lung after plating on to blood agar and McConkey agar and overnight incubation at 37°C. It was provisionally identified as Aeromonas sp on the basis of aerobic growth of a Gram negative rod, being oxidase and catalase positive and showed ,B haemolysis of blood agar. Its final identification as A hydrophila was confirmed by the API 20 NE technique (API System), isolates from the two sources having the same biochemical profiles.Antibiotic sensitivity testing was performed by the comparative disc diffusion method4 on DST agar at 37°C. The organism was resistant to ampicillin, carbenicillin, and cephalothin and sensitive to gentamicin, amikacin, cefuroxime, and co-trimoxazole. Discussion

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Isolated ventricular noncompaction is an extremely rare cardiomyopathy, not fully clarified.It is characterized by persistent embryonic myocardium morphology without associated cardiac abnormalities.Since first description in 1984, few clinical studies were done. Data in the literature are lacking and most reports consist on a few case studies.Doppler ecocardiogram is considered the reference method for diagnosis.Diagnosis remains difficult since there are similarities with other cardiac defects, clinical manifestations are non-specific and echocardiographic criteria are not universally accepted.As a consequence diagnosis may be easily missed.Moreover, clinical and echocardiographic features were just recently clarified.Treatment is directed towards important clinical manifestations (heart failure, arrhythmias and embolic events).We present a clinical case of severe cardio-respiratory failure in previously healthy and asymptomatic young male, which was the initial presentation of an isolated ventricular noncompaction.A brief review of available literature is done concerning to this case study.