Case study of Tsunami patient St George Hospital

This case study shows the sort of polymicrobial/fungal problems that can arise from the disaster.

Information on the patient from Sri Lanka: He is a 56 yo previously well man, injured in the Tsunami whilst in a beach hut in Tangalle and washed 1km inland to a rice paddy with multiple superficial lacerations and 2 deeper soft tissue injuries debrided “locally” and at Colombo hospital to right leg and left iliac crest. No pulmonary/abdo/bone/joint involvement.The microbiology/histopathology coming through to date is as follows:Probable disseminated mucormycosis arising from the deep leg wound Multiresistant E.coli: sensitive to chloro and meropenem onlyMultiresistant GNR, likely Acinetobacter: sensitive to meropenemGNR closest resemblance to Alcaligenes piechaudii: sensitive to ceftazidime, meropenem, pipericillin, timentinPseudomonas aeruginosa: fully sensitiveMRSA from initial swab in one superfical ulcer (on arriva swab): sensitive to vancomycinProbable AeromonasProteussome things on the vibrio plates to be identifiedNo Burkholderia yet!Treated with liposomal amphotericin and now over to POW for HBO; also on meropenem, ciprofloxacin, doxycycline, vancomycin.This will also be posted to EIDIOR and further resistance/susceptibilities will be added.