Classification of Trauma-Associated Invasive Fungal Infections to Support Wound Treatment Decisions

Ganesan, Anuradha; Shaikh, Faraz; Bradley, William; Blyth, Dana M.; Bennett, Denise; Petfield, Joseph L.; Carson, M. Leigh; Wells, Justin M.; Tribble, David R.

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Classification of Trauma-Associated Invasive Fungal Infections to Support Wound Treatment Decisions

Published Date:

Sep 2019

Source:

Emerg Infect Dis. 25(9):1639-1647

Language:

English

[PDF-748.19 KB]

Details:

Personal Authors:

Ganesan, Anuradha ; Shaikh, Faraz ; Bradley, William ; Blyth, Dana M. ; Bennett, Denise ; ... More ▼

Corporate Authors:

Infectious Disease Clinical Research Program Trauma Infectious Disease Outcomes Study Group

Keywords:

[+]

Pubmed ID:

31441428

Pubmed Central ID:

PMC6711217

Description:

To evaluate a classification system to support clinical decisions for treatment of contaminated deep wounds at risk for an invasive fungal infection (IFI), we studied 246 US service members (413 wounds) injured in Afghanistan (2009-2014) who had laboratory evidence of fungal infection. A total of 143 wounds with persistent necrosis and laboratory evidence were classified as IFI; 120 wounds not meeting IFI criteria were classified as high suspicion (patients had localized infection signs/symptoms and had received antifungal medication for >10 days), and 150 were classified as low suspicion (failed to meet these criteria). IFI patients received more blood than other patients and had more severe injuries than patients in the low-suspicion group. Fungi of the order Mucorales were more frequently isolated from IFI (39%) and high-suspicion (21%) wounds than from low-suspicion (9%) wounds. Wounds that did not require immediate antifungal therapy lacked necrosis and localized signs/symptoms of infection and contained fungi from orders other than Mucorales.

Document Type:

Journal Article

Collection(s):

Emerging Infectious Diseases

Funding:

Y01 AI005072/AI/NIAID NIH HHS/United States

Place as Subject:

Afghanistan

Main Document Checksum:

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Supporting Files:

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