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Zygomycosis and the Joplin Tornado



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July 2011

Beyond Hot Topic is an opportunity for viewers to submit questions to the Hot Topic presenter. The opportunity to submit questions for this topic is now closed.

The following questions were submitted by viewers and answered by the presenter, Glenn Roberts, PhD, from the Division of Clinical Microbiology at Mayo Clinic in Rochester, Minnesota. Questions are presented as submitted (unedited).

NOTE: Since the submissions centered around treatment options and protocols, a single answer was written to address all questions.


  1. What course is taken to treat these patients? 

  2. What are the treatments for this disease?

  3. Have there been any more cases? How were they treated?

  4. What is the treatment protocol for Zygomycete infections?

  5. How is this infection treated?

  6. Were they able to successfully treat these patients?

    As best that I can determine, there were a total of 13 confirmed cases of soft tissue mucormycosis caused by Apophysomyces trapeziformis. No additional cases have been reported since June 17.

    After speaking to one of the clinicians who treated some of the patients, he mentioned that there was no standard protocol used to treat these patients since this type of injury caused by a tornado has never been reported before. Treatment of the cases included surgical debridement to remove foreign bodies and infected tissue. Antifungal therapy was given to some patients and I am sure that patients were treated differently depending on their physician. Ten of the patients required admission to an intensive care unit and, unfortunately, 5 of them died but I am not sure whether or not it was due to the fungal infection or not.

    This was a very difficult situation for all involved and everyone tried to do the best that they could. We really have to be proud of the caregivers and all of the people of Joplin who suffered so much. I am sure that something good will come from this and that someone will draft some guidelines so that we know exactly what to do if this type of disaster occurs again.


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