Latenser Barbara A
Department of Trauma, Sumner L. Koch Burn Center, Cook County Hospital, Chicago, Illinois 60612, USA.
J Burn Care Rehabil. 2003 Sep-Oct;24(5):285-8. doi: 10.1097/01.BCR.0000085845.20730.AB.
Fusarium species, or saprophytic molds, are important plant pathogens and recognized as agents of human mycotic infections. Frequently superficial, deep-tissue involvement, and dissemination occurs in immunocompromised hosts with hematologic malignancies, aplastic anemia, and chemotherapy treatment. Presented in this work is a burn patient with a fatal disseminated infection in addition to a review of the literature. A 40-year-old white male acquired a 73% grease scald injury at work. His hospital course was interspersed with multiple episodes of Flavobacterium, Fusarium, Candida, Proteus, Enterococcus, coagulase-negative Staphylococcus, and Serratia infections. He underwent nine operative procedures for debridement, excision, and skin grafting. The last operative procedure included bilateral below knee amputations to halt an invasive Fusarium infection that was invading normal unburned skin. The patient died 55 days after injury. Fusarium and Aspergillus infections are frequently confused and do not have characteristic clinical features. With the prolonged survival of severely burned patients, better fungal diagnostic and treatment modalities are needed to improve outcome.
镰刀菌属，即腐生霉菌，是重要的植物病原体，也是公认的人类真菌感染病原体。感染通常累及体表，在免疫功能低下的血液系统恶性肿瘤、再生障碍性贫血及接受化疗的患者中可出现深部组织感染及播散。本文报告了1例烧伤患者发生致命性播散性感染，并对相关文献进行综述。1例40岁白人男性在工作中遭受73%体表面积的油脂烫伤。其住院期间多次发生黄杆菌、镰刀菌、念珠菌、变形杆菌、肠球菌、凝固酶阴性葡萄球菌及沙雷菌感染。他接受了9次清创、切除及植皮手术。最后一次手术包括双侧膝下截肢，以阻止侵袭正常未烧伤皮肤的侵袭性镰刀菌感染。患者于受伤后55天死亡。镰刀菌感染和曲霉菌感染常易混淆，且无特征性临床特点。随着严重烧伤患者生存期延长，需要更好的真菌诊断和治疗方法以改善预后。
