Invasive fungal infections in wars, following explosives and natural disasters: A narrative review

Area of Science:

• Medical Mycology
• Infectious Diseases
• Trauma Care

Background:

• Traumatic injuries frequently lead to infections, increasing morbidity and mortality.
• Disaster settings (natural, man-made, or war) present unique challenges for managing trauma patients.
• Invasive fungal infections (IFI) are increasingly observed in trauma patients, even those without typical risk factors.

Purpose of the Study:

• To review the epidemiology, clinical features, risk factors, microbiology, and management of IFI in trauma patients from disaster settings.
• To highlight the importance of considering IFI in mass casualty incidents and conflict zones.
• To summarize current evidence on IFI in this specific patient population.

Main Methods:

• Narrative review of existing literature.
• Focused on IFI as a complication of trauma in natural disasters, wars, and man-made mass destruction.
• Summarized data on incidence, clinical presentation, and treatment.

Main Results:

• IFI can manifest as skin/soft tissue infections, osteomyelitis, visceral infections, or pneumonia in trauma patients.
• Exposure to unsterile environments or wounds contaminated with soil/organic matter increases IFI risk.
• IFI should be suspected in patients with war-inflicted injuries and contaminated wounds.

Conclusions:

• IFI represent a significant and increasing complication in trauma patients, particularly in disaster scenarios.
• Awareness and consideration of IFI are essential for effective patient management in mass casualty and conflict settings.
• Further research is needed to fully understand and combat IFI in these challenging environments.