Obradovic Alexandra, Hajdu Stefan, Presterl Elisabeth
Universitätsklinik für Unfallchirurgie, Medizinische Universität Wien, Wien, Osterreich.
Wien Med Wochenschr. 2007;157(19-20):482-9. doi: 10.1007/s10354-007-0463-1.
Perforating injury allows the dispersion of environmental fungi and fungal spores together with miniscule foreign bodies into traumatized tissue where they can multiply and cause invasive infection. Acute invasive fungal infection after open fractures is uncommon. The severity of the fungal infections depends on the type of injury (perforating, presence of foreign material), the body area and the general condition of the patient. Fungal infections of the immuncompetent host are generally localized within the dermis, invasion of the fascia, muscles and the bone is rare. Injury-related fungal infections of the immuncompromised host may lead to rapid invasion and generalization of the fungal infection. The following review will focus on the fungal infections after perforating injuries and open fractures including the invasive mycoses as a direct consequence of the trauma, post-traumatic fungal infections, tropical fungal infections (mycetoma), invasive fungal infections after near-drowning and nosocomial invasive fungal infections of the critically ill post-traumatic patient admitted to the intensive care unit.
贯通伤会使环境中的真菌、真菌孢子与微小异物一起散布到受创伤的组织中，在那里它们能够繁殖并引发侵袭性感染。开放性骨折后发生急性侵袭性真菌感染并不常见。真菌感染的严重程度取决于损伤类型（贯通伤、是否存在异物）、身体部位以及患者的一般状况。免疫功能正常宿主的真菌感染通常局限于真皮层，侵犯筋膜、肌肉和骨骼的情况较为罕见。免疫功能低下宿主与损伤相关的真菌感染可能导致真菌感染迅速侵袭并扩散。以下综述将聚焦于贯通伤和开放性骨折后的真菌感染，包括作为创伤直接后果的侵袭性真菌病、创伤后真菌感染、热带真菌感染（足菌肿）、近乎溺水后的侵袭性真菌感染以及入住重症监护病房的创伤后重症患者的医院获得性侵袭性真菌感染。
