Mucormycosis in Burns: A Review

Area of Science:

• Medical Mycology
• Infectious Diseases
• Burn Care

Background:

• Mucormycosis is a rare fungal infection with high mortality.
• It presents as necrotic ulcers and wound progression despite debridement.
• No comprehensive review of burn-related mucormycosis exists.

Purpose of the Study:

• To provide the first evidence-based treatment guidance for burn-related mucormycosis.
• To review existing literature on mucormycosis complicating burns.
• To analyze treatment outcomes and mortality rates.

Main Methods:

• Systematic review of publications from 1946 to the present.
• Analysis of 151 cases of mucormycosis complicating burns.
• Evaluation of treatment modalities including debridement, systemic and topical antifungals, and hyperbaric oxygen.

Main Results:

• The mortality rate for burn-related mucormycosis was 54.5%.
• Axial body site involvement significantly increased mortality.
• Prompt, radical debridement was the standard treatment; frozen section aided decision-making.
• Amphotericin B showed a trend toward significance in systemic treatment.

Conclusions:

• Early radical debridement is crucial.
• Recommended treatment: IV liposomal/lipid complex amphotericin B (>5mg/kg/day) with posaconazole (800 mg daily) as salvage or step-down therapy.
• Topical amphotericin B and hyperbaric oxygen may offer benefits in select cases.