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Author Spotlight: Studying Host-Microbe Interactions in Wound Biofilm Formation
Published on: June 16, 2023
Mould Infections of Traumatic Wounds: A Brief Narrative Review
Daniele Roberto Giacobbe1,2, Niccolò Riccardi3, Antonio Vena4,5
1Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy. daniele.roberto.giacobbe@edu.unige.it.
Abstract:
Mould infections may follow traumatic injuries, with direct fungal inoculum in the site of injury and subsequent angioinvasion, possibly resulting in tissue necrosis and systemic dissemination. The pathogenesis of mould infections following trauma injuries presents unique features compared with classical mould infections occurring in neutropenic or diabetic patients, because a large fraction of post-traumatic mould infections is observed in previously healthy individuals. Most of the published clinical experience and research on mould infections following traumatic injuries regards soldiers and infections after natural disasters. However, following trauma and soil contamination (e.g., agricultural or automotive injuries) other immunocompetent individuals may develop mould infections. In these cases, delays in correct diagnosis and treatment may occur if pertinent signs such as necrosis and absent or reduced response to antibacterial therapy are not promptly recognized. Awareness of mould infections in at-risk populations is needed to rapidly start adequate laboratory workflow and early antifungal therapy in rapidly evolving cases to improve treatment success and reduce mortality.
Insights
Mould infections can occur after traumatic injuries, even in healthy individuals, leading to tissue damage and potential spread. Early recognition of signs like necrosis and lack of response to antibiotics is crucial for timely diagnosis and antifungal treatment.
Area of Science:
- Mycology
- Infectious Diseases
- Trauma Surgery
Background:
- Mould infections post-trauma differ from those in immunocompromised patients, often affecting previously healthy individuals.
- Clinical data primarily focuses on soldiers and natural disaster survivors, overlooking other at-risk populations.
- Trauma with soil contamination, such as agricultural or automotive injuries, can lead to mould infections in immunocompetent individuals.
Purpose of the Study:
- To highlight the unique features of mould infections following traumatic injuries.
- To emphasize the importance of recognizing specific clinical signs for prompt diagnosis.
- To advocate for increased awareness and early antifungal therapy in at-risk populations.
Main Methods:
- Review of clinical presentations and pathogenesis of post-traumatic mould infections.
- Comparison with mould infections in neutropenic and diabetic patients.
- Analysis of diagnostic and therapeutic challenges in immunocompetent individuals.
Main Results:
- Post-traumatic mould infections can occur in healthy individuals following direct fungal inoculation and angioinvasion.
- Necrosis and lack of response to antibacterial therapy are key indicators.
- Delays in diagnosis and treatment are common, impacting outcomes.
Conclusions:
- Mould infections following trauma present distinct challenges, particularly in immunocompetent individuals.
- Prompt recognition of clinical signs and initiation of antifungal therapy are vital for improving patient outcomes.
- Increased awareness among healthcare providers is essential for managing these infections effectively.
