Respiratory Complication of Tsunami Victims in Phuket and Phang-Nga
Pairaj Kateruttanakul, MD*, Wilai Paovilai, MD*, Subsai Kongsaengdao, MD*, Sakarn Bunnag, MD*, Kriangsak Atipornwanich, MD*, Napha Siriwatanakul, MD*
Affiliation : * Department of Medicine, Rajavithi Hospital
In the present report the authors describe the clinical and laboratory findings of 26 tsunami victims
admitted to the Phuket and the Takua Pa Hospital. Patients were classified into 4 groups of severity: class 1,
baseline examination negative (n = 1); class 2, baseline examination positive but mechanical ventilation
not needed on admission (n = 15); class 3, mechanical ventilation required on admission (n = 9); class 4,
cardiopulmonary arrest (n = 1). On admission, 21/23 patients had fever of > 37.5 C. 3/10 patients had
hypernatremia and 7/10 cases had metabolic acidosis.
The radiological manifestation varied from focal disease to diffuse infiltrations, either
reticulonodular or patchy lesions. There were 3 clinical courses among diffuse diseases: 1) diffuse infiltra-
tions and progression 3 cases 2) diffuse infiltration, early regression followed by progression 2 cases 3)
diffuse infiltration and steady regression 5 cases.
Late complications comprised of pneumothorax/pneumomediastinum (n = 5) and bacterial pneu-
monia (n = 18). The authors got culture data in 9 patients, most of them were infected with aerobic gram -ve
bacteria and 2 of them were B. pseudomallei. The prognosis in the tsunami related medical illness was
favorable. Only 2 patients (7.7%) died in the present study.
Keywords : Tsunami, Seawater near-drowning, Pulmonary edema, B. pseudomallei
