Xuan Hai Tang, Thai Ngoc Minh Nguyen, Ngoc Anh Do, Ngoc Dung Tran, Thi Minh Chau Ngo, Tran-Anh Le
Department of Otorhinolaryngology, Nghe An Obstetrics and Pediatrics Hospital, Vinh, Vietnam.
Intensive Care Unit, National Hospital of Burn, Vietnam Military Medical University, Hanoi, Vietnam.
Curr Med Mycol. 2021 Mar;7(1):59-62. doi: 10.18502/cmm.7.1.6245.
Burn injuries are prone to infection caused by bacteria, fungi, or other pathogens. Fungal wound infection usually has non-specific clinical symptoms. Nevertheless, in some cases, the fungal burden is so substantial that can easily be seen by the naked eyes, but this phenomenon has rarely been reported with .
A 53-year-old patient with severe burn injury was admitted to the intensive care unit of the National Hospital of Burn, Ha Noi, Vietnam. His wound was dressed with a traditional herbal product before the hospital admission. On the 5th day after the admission, some white patches suspected of fungal colonies appeared on burn lesions where the herbal medicine was placed. Histological examination (Periodic acid-Schiff) and culture of biopsy samples taken from those lesions revealed fungus that was identified as after analysis of the internal transcribed spacer and D1/D2 region of the large subunit of the 28S rDNA. The isolated strain showed susceptibility to voriconazole but resistance to fluconazole, itraconazole, caspofungin, and amphotericin B . The patient received aggressive treatment, including IV voriconazole (400 mg daily from day five); however, he could not recover.
should be suspected in burn patients with white patches on lesions. Antifungal susceptibility testing is important since multidrug resistance is common among strains.
烧伤创面容易受到细菌、真菌或其他病原体感染。真菌性创面感染通常具有非特异性临床症状。然而，在某些情况下，真菌负荷量很大，肉眼很容易看到，但这种现象鲜有报道。
一名53岁重度烧伤患者入住越南河内国家烧伤医院重症监护病房。入院前其创面用一种传统草药产品包扎。入院后第5天，在放置草药的烧伤创面上出现了一些疑似真菌菌落的白色斑块。对这些病变部位采集的活检样本进行组织学检查（过碘酸希夫染色）和培养，经分析28S rDNA大亚基的内转录间隔区和D1/D2区域后，鉴定出真菌为 。分离出的菌株对伏立康唑敏感，但对氟康唑、伊曲康唑、卡泊芬净和两性霉素B耐药。患者接受了积极治疗，包括静脉注射伏立康唑（从第5天起每日400mg）；然而，他未能康复。
创面有白色斑块的烧伤患者应怀疑 感染。由于 菌株中多重耐药很常见，因此进行抗真菌药敏试验很重要。
