Thursday, August 28, 2014

Joplin Tornado Victims Killed by Fungus

June 10, 2011 by  
Filed under Science, Uncategorized

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A Joplin doctor said Thursday his hospital treated five Joplin tornado victims for a rare, aggressive fungal infection sometimes found in survivors of other natural disasters, reports St. Louis CBS affiliate KMOX.

Dr. Uwe Schmidt, an infectious disease specialist at Freeman Health System in Joplin, said three of those patients who contracted zygomycosis have since died, but he stopped short of blaming their deaths specifically on the infections.

“These people had multiple traumas, pneumonia, all kinds of problems,” Schmidt said. “It’s difficult to say how much the fungal infections contributed to their demise.”

Zygomycosis, now known as mucormycosis, is a fungal infection that spreads rapidly and can be caused by soil or vegetative material becoming embedded under the skin. It’s more prevalent in people with weakened immune systems or untreated diabetes but can affect healthy people who suffer trauma and are injected with contaminated soil.

Dr. Benjamin Park with the Centers for Disease Control and Prevention said people who have had a traumatic skin injury that is not improving should seek medical attention immediately so the infection can be identified and treated promptly.

Here is a portion of the memo from health care authorities:

“Dear Greene County Medical Providers,

The Springfield-Greene County Health Department was made aware of medical concerns associated with tornado victims. Please see the statement below:

All Medical Providers Caring for Joplin Tornado Victims

Several patients have been identified recently with aggressive fungal soft tissue infections. These patients were transferred in from the field and had lacerations that were closed at the scene. These patients have developed cellulitis followed by aggressive necrotizing soft tissue infection. Despite aggressive surgical debridement, the wounds have continued to advance. Microscopy demonstrates invasive fungal elements with capillary thrombosis. Grossly, the wounds have a cellulitic appearance with necrosis of the deeper aspect of the wound. The fat has a saponified appearance. In some cases gross fungal elements are visible with the naked eye. Despite aggressive surgical debridement, the necrosis reoccurs within 24 hours. Treatment currently consists of aggressive serial surgical debridement with IV amphotericin therapy.”

“These fungal infections are usually quite serious, and often have a case-fatality rate of 50 percent or higher,” Park said in an email to The Associated Press. “Although persons with weakened immune systems and those with diabetes are the most common risk groups, otherwise healthy people can develop infection, particularly after a traumatic wound. Skin infection usually occurs following traumatic inoculation of the fungal spores into the skin.”

Schmidt said he had seen only two cases of zygomycosis in his 30 years of practice, and both of those cases involved people with untreated diabetes.

“I never have seen personally this kind of fungal infection of the skin,” he said.

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