Pneumonia after Earthquake, Japan, 2011

Streptomyces pneumonia in an immu-nocompetent patient: a case report and literature review.related bacteremia due to Streptomyces in a patient receiving holistic infusions. Case report of Strep-tomyces endocarditis of a prosthetic aortic valve. The anergic state in sarcoidosis is associated with diminished dendritic cell function. triggered an extremely destructive tsunami (1), which destroyed cities along the Pacifi c coastline in the Tohoku area and resulted in the loss of >19,000 human lives. Water from the tsunami inundated ≈33.7% of Tagajo City (population ≈61,000) and caused 188 deaths. Many local residents were left without lifeline utilities, including electricity, gas, water, or any means of transportation and thus were forced to live in crowded shelters or limited small spaces (e.g., the upper fl oor of their home); ≈11,000 persons were displaced from their damaged or destroyed homes to crowded school gymnasiums or community centers. In March, the mean daily maximum air temperature in Tagajo City was cold (8°C/46.4°F). After the earthquake, cases of pneumonia increased rapidly. Saka General Hospital is located in this region near the coast. The destruction around the hospital was so severe that persons were without electricity, water, gas, and fuel for several weeks. Fortunately, the hospital laboratory was almost completely functional and could perform bacterial and other tests at a near-normal level, despite the earthquake. However, several other hospitals in the area were severely damaged and thus had diffi culty treating patients with severe pneumonia. To determine the characteristics of pneumonia after the earthquake, we conducted a retrospective study of patients who had pneumonia during the 6 weeks before the earthquake and the fi rst 9 weeks after the earthquake. To identify patients with pneumonia, we checked all chest radiographs and computed tomography scans of adult patients (>16 years of age) who had visited the hospital. We examined clinical and bacteriologic data for these patients. We excluded from the study patients without sputum culture and patients with other conditions, such as lung cancer, pulmonary infarction, or cardiac failure. During the 6 weeks before the earthquake, pneumonia had been diagnosed for 49 adults (controls), and within the 9 weeks after the earthquake, community-acquired or health care– associated pneumonia was newly diagnosed for 172 adults. Patient data from 2 pre-earthquake periods and 3 postearthquake periods are shown in the Table. Although the number of patients with pneumonia in the fi rst 3 weeks after the earthquake increased sharply, no substantial differences …