The Joplin Fungus - Adding Illness to Injury

A rare, very aggressive fungus infection known as zygomycosis has been found in at least 5 victims of the Joplin tornado.  Three of them have died, but it is not clear whether the fungus led to their deaths:

Several patients have been identified recently with aggressive fungal soft tissue infections. These patients were transferred in from the field and had lacerations that were closed at the scene. These patients have developed cellulitis followed by aggressive necrotizing soft tissue infection. Despite aggressive surgical debridement, the wounds have continued to advance. Microscopy demonstrates invasive fungal elements with capillary thrombosis. Grossly, the wounds have a cellulitic appearance with necrosis of the deeper aspect of the wound. The fat has a saponified appearance. In some cases gross fungal elements are visible with the naked eye. Despite aggressive surgical debridement, the necrosis reoccurs within 24 hours. Treatment currently consists of aggressive serial surgical debridement with IV amphotericin therapy.”

“These fungal infections are usually quite serious, and often have a case-fatality rate of 50 percent or higher,” Park said in an email to The Associated Press. “Although persons with weakened immune systems and those with diabetes are the most common risk groups, otherwise healthy people can develop infection, particularly after a traumatic wound. Skin infection usually occurs following traumatic inoculation of the fungal spores into the skin.”

When they say " gross fungal elements are visible with the naked eye"; do they mean mushrooms?  Now that would be disturbing.