Pamela Konecny (St George Hospital, Sydney, Australia) and colleagues describe the first case of a fungal infection, called mucormycosis, identified in a 56-year-old man who was transferred from Sri Lanka to a Sydney hospital for treatment after being injured when the tsunami hit on December 26, 2004.
The mainstay treatment for mucormycosis is early surgical intervention to remove all dead an infected tissue, along with intravenous and antifungal therapy. Mucormycosis has a high mortality rate even with aggressive surgical intervention. Death rates range from 20-80% depending on the site involved and whether the patient has any underlying immune problems.
The authors believe that infections found in travellers who have returned from tsunami-affected regions can inform those treating survivors who remain in the area.
Dr Konecny comments: "Wound infections, both bacterial and fungal, will undoubtedly add to the illness and mortality already recorded in tsunami-affected areas. Other cases of mucormycosis might develop in survivors, but this disease can be difficult to diagnose and even harder to treat, particularly in those who remain in affected regions.
She adds: "This case shows that travellers repatriated from affected areas could be good predictors of infections in survivors because they may have greater access to advanced diagnostic services than do those who remain."
Dr Pamela Konecny, Department of Immunology & Infectious Diseases, Staff Specialist Infectious Diseases, St George Hospital, 2 South Street, Kogarah NSW 2217, Australia.
T) 61-293-502-955
konecnyp@sesahs.nsw.gov.au
The Lancet