Topical nystatin powder in severe burns: a new treatment for angioinvasive fungal infections refractory to other topical and systemic agents.
Angioinvasive fungal infections have a significant morbidity and mortality in the immunocompromised host. Massive burns produce a profound derangement in cellular immunity along with a loss of cutaneous barrier function. Treatment of fungal burn wound infections poses a difficult therapeutic challenge. We present a new method of treatment for angioinvasive fungal infections with nystatin powder at a concentration of 6,000,000 units/g. It proved to be efficacious in four consecutive severely burned patients affected by massive angioinvasive fungal infection. Both superficial and deep tissue infections were eradicated without any other therapeutic interventions or adverse effects on wound healing.
Barret
J P
JP
Shriners Burns Hospital, The University of Texas Medical Branch, Galveston 77550, USA. jbarret@sbi.utmb.edu
Ramzy
P I
PI
Heggers
J P
JP
Villareal
C
C
Herndon
D N
DN
Desai
M H
MH
D000287:Administration, Topical; D000935:Antifungal Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001230:Aspergillus / Q000302:isolation & purification; D001706:Biopsy; D002056:Burns / Q000188:drug therapy* / Q000382:microbiology / Q000473:pathology; D002648:Child; D004359:Drug Therapy, Combination; D005670:Fusarium / Q000302:isolation & purification; D006801:Humans; D017964:Itraconazole / Q000627:therapeutic use; D009181:Mycoses / Q000188:drug therapy* / Q000382:microbiology / Q000473:pathology; D009761:Nystatin / Q000008:administration & dosage / Q000627:therapeutic use*; D011208:Powders; D012189:Retrospective Studies; D016038:Skin Transplantation; D015599:Trauma Severity Indices; D016896:Treatment Outcome; D014945:Wound Healing / Q000187:drug effects; D014946:Wound Infection / Q000188:drug therapy* / Q000382:microbiology / Q000473:pathology
D000935:Antifungal Agents; D011208:Powders; D009761:Nystatin; D017964:Itraconazole