FUNGAL INFECTIONS AFTER A TORNADO

The history of the recent severe tornado that struck Joplin Missouri on 5/22/11 is

well known. In the July 29,2011 MMWR–18 cases of a very unusual

severe skin infection -mucormycosis is described in Joplin residents. This

infection is usually seen only in Diabetics ,cancer patients or other

immunosuppressive conditions.13 confirmed cases ar described in the report.These

patients had all been injured in the tornado with an average of 4 wounds documented

in the ER medical charts.Medical management included surgical debridement

and removing of foreign body–wooden splinters were most common.2 of the

patients had Diabetes and none were considered immunocompromised. 10/13

required ICU admit and 5/13 (38%) died.The specific organism within the

order Mucormycete was Apophysomyces trapeziformis.This has been associated

with traumatic implantation of fungal spores.This is the first known cluster of this

fungal infection following a tornado.