Mucormycosis in Burn Patients

Area of Science:

• Mycology
• Infectious Diseases
• Burn Care

Background:

• Patients with extensive burns are susceptible to opportunistic fungal infections.
• Cutaneous mucormycosis presents a significant challenge in burn wound management.
• Limited data exists on the epidemiology and clinical characteristics of mucormycosis in burn patients.

Purpose of the Study:

• To systematically review reported cases of cutaneous mucormycosis in burn patients from 1990 onwards.
• To analyze the prevalence, clinical features, diagnostic methods, treatment, and outcomes.
• To identify risk factors and potential sources of infection.

Main Methods:

• Systematic literature search of Medline for case series, outbreaks, and individual case reports of mucormycosis in burn patients since 1990.
• Data extraction on patient demographics, burn characteristics, clinical presentation, diagnostic methods, treatments, and outcomes.
• Analysis of prevalence, mortality rates, and causative fungal species.

Main Results:

• The review identified 7 case series, 3 outbreaks, and 25 individual case reports.
• Prevalence ranged from 0.04% to 0.6%, with high mortality (33%-100%).
• Diagnosis often relied on extensive necrotic lesions and sepsis; Mucorales qPCR detected DNA earlier than standard methods.

Conclusions:

• Cutaneous mucormycosis in burn patients is associated with high mortality.
• Early diagnosis, potentially aided by Mucorales qPCR, and aggressive management including debridement are crucial.
• Nosocomial transmission via bandages and environmental exposure (soil) are potential sources.