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Invasive Fungal Infections Secondary to Traumatic Injury
Ryan Kronen1, Stephen Y Liang2, Grant Bochicchio3
1Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine, 660 S. Euclid Ave., St. Louis, MO, USA.
Abstract:
Invasive fungal infection (IFI) is a rare but serious complication of traumatic injury. The purpose of this article is to review the epidemiology, natural history, mycology, risk factors, diagnosis, treatment, and outcomes associated with post-traumatic IFI in military and civilian populations. The epidemiology of post-traumatic IFI is poorly characterized, but incidence appears to be rising. Patients often suffer from severe injuries and require extensive medical interventions. Fungi belonging to the order Mucorales are responsible for most post-traumatic IFI in both civilian and military populations. Risk factors differ between these cohorts but include specific injury patterns and comorbidities. Diagnosis of post-traumatic IFI typically follows positive laboratory results in the appropriate clinical context. The gold standard of treatment is surgical debridement in addition to systemic antifungal therapy. Patients with post-traumatic IFI may be at greater risk of amputation, delays in wound healing, hospital complications, and death as compared to trauma patients who do not develop IFI. More research is needed to understand the factors surrounding the development and management of post-traumatic IFI to reduce the significant morbidity and mortality associated with this disease.
Insights
Post-traumatic invasive fungal infections (IFIs), often caused by Mucorales fungi, are a serious complication of severe injuries. Rising incidence highlights the need for better understanding and management to reduce patient morbidity and mortality.
Area of Science:
- Medical Mycology
- Infectious Diseases
- Trauma Surgery
Background:
- Invasive fungal infection (IFI) is a rare but severe complication following traumatic injury.
- The incidence of post-traumatic IFI appears to be increasing, particularly in patients with severe injuries requiring extensive medical interventions.
Purpose of the Study:
- To review the epidemiology, natural history, mycology, risk factors, diagnosis, treatment, and outcomes of post-traumatic IFI.
- To compare these aspects between military and civilian populations.
Main Methods:
- Literature review synthesizing data on post-traumatic IFI.
- Analysis of epidemiological trends, causative fungal agents (primarily Mucorales), and risk factors specific to civilian and military cohorts.
- Evaluation of diagnostic approaches, treatment strategies (surgical debridement and antifungal therapy), and patient outcomes.
Main Results:
- Post-traumatic IFI epidemiology is not well-characterized but shows a rising incidence.
- Mucorales fungi are the predominant cause of IFIs in both civilian and military trauma patients.
- Patients with post-traumatic IFI face increased risks of amputation, delayed wound healing, hospital complications, and mortality.
Conclusions:
- Post-traumatic IFI is associated with significant morbidity and mortality.
- Differences in risk factors exist between civilian and military populations.
- Further research is crucial to improve the understanding and management of post-traumatic IFI to mitigate its severe consequences.
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