1. Severe filamentous fungal infections after widespread tissue damage due to traumatic injury: Six cases and review of the literature
- Author
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B. Lebeau, Dominique Falcon, Christian Piolat, Odile Faure, Hervé Pelloux, Emmanuelle Bozonnet, Renée Grillot, Philippe Pradel, Axel Aubert, Virginie Vitrat-Hincky, Laboratoire de parasitologie et mycologie, Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble, Deparment of Infectiology and Tropical Diseases, Department of Plastic and Maxillo-Facial Surgery, Surgical Intensive Care Unit, Department of Hand Surgery and Burns, Department of Vascular Surgery, Department of Pediatric General Surgery, Laboratoire Adaptation et pathogénie des micro-organismes [Grenoble] (LAPM), and Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)
- Subjects
Microbiology (medical) ,Mucorales ,Adult ,Male ,medicine.medical_specialty ,Necrosis ,Adolescent ,medicine.medical_treatment ,Poison control ,03 medical and health sciences ,Soil ,0302 clinical medicine ,Medicine ,Humans ,[SDV.BBM]Life Sciences [q-bio]/Biochemistry, Molecular Biology ,030212 general & internal medicine ,Child ,Mycosis ,0303 health sciences ,Aspergillus ,General Immunology and Microbiology ,biology ,030306 microbiology ,business.industry ,Aspergillus fumigatus ,Accidents, Traffic ,Fungi ,General Medicine ,Middle Aged ,biology.organism_classification ,medicine.disease ,Prognosis ,Dermatology ,3. Good health ,Surgery ,Fungicide ,Infectious Diseases ,Traumatic injury ,Amputation ,Mycoses ,Mucor ,Child, Preschool ,Wounds and Injuries ,Female ,France ,medicine.symptom ,business - Abstract
International audience; 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.
- Published
- 2009
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