ORIGINAL ARTICLES
IMAJ | volume 28
Journal 9, September 2026
pages: 584-589
Imaging Findings in Patients with Near-drowning Incidents in the Dead Sea and Their Correlation with Clinical Outcomes
1 Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
2 Department of Internal Medicine F, Soroka University Medical Center, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
3 Department of Radiology, Soroka University Medical Center, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
4 Cardiologic Intensive Care Unit, Soroka University Medical Center, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
5 Internal Medicine Outpatient Ward, Soroka University Medical Center, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
Summary
Background:
The Dead Sea is a hypersaline lake with unique mineral concentrations. Ingestion and aspiration of its water can lead to severe electrolyte imbalances and chemical pneumonitis.
Objectives:
To evaluate imaging findings from Dead Sea near-drowning victims and to correlate these findings with clinical outcomes.
Methods:
We conducted a retrospective study of patients (age > 18 years) admitted to a tertiary medical center between 2004 and 2024 following Dead Sea near-drowning. Imaging studies were categorized by a radiology expert into normal, interstitial changes, unilateral consolidation, or bilateral consolidation. Clinical outcomes, including mortality and intensive care unit (ICU) admission, were analyzed across the groups.
Results:
Of the 150 patients identified, 68.7% (n=103) had normal chest X-rays. Abnormal findings included bilateral consolidation 12.7% (n=19), unilateral consolidation 9.3% (n=14), and interstitial changes 9.3% (n=14). Patients with bilateral consolidation had significantly higher peak serum magnesium (median
10.5 vs.
3.1 mg/dl in the normal group;
P < 0.001) and peak calcium (median
13.1 vs.
10.3 mg/dl;
P < 0.001). Bilateral consolidation was a strong predictor of severity: 26.3% in-hospital mortality rate compared to 1% in the group with normal X-rays (
P < 0.001). ICU admission was required for 78.9% of patients with bilateral consolidation and 71.4% with interstitial changes (
P < 0.001).
Conclusion:
Radiologic findings in Dead Sea near-drownings are predictive of clinical trajectory. Bilateral alveolar consolidation is an indication of massive mineral aspiration, severe hypermagnesemia, and high mortality. Early imaging is essential for risk stratification and for determining the level of care required.