title: Tetanus, pneumonia, and malaria in a tsunami victim in Banda Aceh, Indonesia.
abstract: On December 26, 2004, a tsunami from the Indian Ocean struck the coastal city of Banda Aceh, Sumatra, Indonesia. This case report describes a 24-year-old woman who presented to the Dr. Zainoel Abidin Hospital in Banda Aceh on January 8, 2005, with a tsunami-related illness. The patient was initially treated for tetanus and aspiration pneumonia with a guarded prognosis. Her recovery was complicated by malaria and recurrent pneumonia. Treatment was hampered by a shortage of medication and equipment, damage to the hospital, and a filthy environment. Morphine, diazepam, and ketamine infusions were used to good effect. This case highlights some of the logistical problems of treating multiple tetanus patients in an austere environment.
authors.affiliation: Royal Australian Army Medical Corps, Australian Regular Army, 1st Health Support Battalion, Manunda Lines, Holsworthy Barracks, Sydney, New South Wales 2173.
authors.forename: Mark R
authors.initials: MR
authors.lastname: Hanley
authors.forename: William
authors.initials: W
authors.lastname: O'Regan
authors.forename: Scott
authors.initials: S
authors.lastname: Squires
authors.forename: Charmaine
authors.initials: C
authors.lastname: Tate
mesh_terms: D000328:Adult; D002443:Ceftriaxone; D003975:Diazepam; D004190:Disasters; D005260:Female; D006801:Humans; D007214:Indonesia; D008288:Malaria / Q000175:diagnosis* / Q000188:drug therapy; D008795:Metronidazole; D011014:Pneumonia / Q000175:diagnosis* / Q000188:drug therapy; D011379:Prognosis; D013742:Tetanus / Q000175:diagnosis*
chemical_list: D008795:Metronidazole; D002443:Ceftriaxone; D003975:Diazepam