…As of July 19, a total of 18 suspected cases of cutaneous mucormycosis had been identified, of which 13 were confirmed.
A confirmed case was defined as 1) necrotizing soft-tissue infection requiring antifungal treatment or surgical debridement in a person injured in the tornado, 2) with illness onset on or after May 22, and 3) positive fungal culture or histopathology and genetic sequencing consistent with a Mucormycete. No additional cases have been reported since June 17.
The field team reviewed medical charts to describe the 13 confirmed cases. The median age of the patients was 48 years (range: 13—76 years); seven were female, and all were white. Injuries sustained during the tornado included lacerations (12 patients), fractures (11), and blunt trauma (nine). The 13 patients had an average of four wounds documented in the medical chart when they were examined at the emergency department. Post-trauma wound management included surgical debridement for all 13 patients and removal of a foreign body from six. Wooden splinters were the most common foreign body, found in the wounds of four patients. Two patients had diabetes, and none were immunocompromised.
Ten patients required admission to an intensive-care unit, and five died.
Cutaneous mucormycosis is a rare infection caused by fungi of the order Mucorales, which typically are found in soil and decaying wood and other organic matter. Although cutaneous mucormycosis often is opportunistic, affecting patients with diabetes, hematologic malignancy or solid organ transplant, A. trapeziformis often is associated with immunocompetent hosts after traumatic implantation of fungal spores.
The case-fatality rate for cutaneous mucormycosis has ranged from 29% to 83%, depending on severity of disease and underlying medical condition of the patient…
