Severe filamentous fungal infections after widespread tissue damage due to traumatic injury: six cases and review of the literature.
We describe 6 cases of severe filamentous fungal infections after widespread tissue damage due to traumatic injury in previously healthy people. Additionally, we report 69 cases from an exhaustive 20-y review of the literature to investigate the epidemiological and clinical features, the prognosis and the therapeutic management of these post-traumatic severe filamentous fungal infections. Traffic (41%) and farm accidents (25%) were the main causes of injury, which involved either the limbs only (41%) or multiple sites (41%). Necrosis was the main symptom (60%) and Mucorales (72%) and Aspergillus (11%) were the 2 most frequent fungi causing infection. These infections required substantial surgical debridement or amputation (96%) associated with aggressive antifungal therapy (81%), depending on the responsible fungi. This study underlines the need for early, repeated and systematic mycological wound samples to guide and adapt surgical and antifungal management in these filamentous fungal infections.
Vitrat-Hincky
Virginie
V
Parasitology and Mycology Laboratory, Grenoble University Hospital, Grenoble, France. Vhinckyvitrat@chu-grenoble.fr
Lebeau
Bernadette
B
Bozonnet
Emmanuelle
E
Falcon
Dominique
D
Pradel
Philippe
P
Faure
Odile
O
Aubert
Axel
A
Piolat
Christian
C
Grillot
Renée
R
Pelloux
Hervé
H
D000063:Accidents, Traffic; D000293:Adolescent; D000328:Adult; D001232:Aspergillus fumigatus / Q000302:isolation & purification; D002648:Child; D002675:Child, Preschool; D005260:Female; D005602:France / Q000453:epidemiology; D005658:Fungi / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009089:Mucor / Q000302:isolation & purification; D009181:Mycoses / Q000453:epidemiology / Q000209:etiology* / Q000382:microbiology; D009336:Necrosis; D011379:Prognosis; D012987:Soil; D014947:Wounds and Injuries / Q000453:epidemiology / Q000382:microbiology*
D012987:Soil