School of Medicine, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA.
Trauma and Critical Care, Department of Surgery, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA.
Surg Infect (Larchmt). 2022 Aug;23(6):550-557. doi: 10.1089/sur.2021.325. Epub 2022 Jun 8.
Invasive fungal infections, most commonly caused by species, are an underrecognized sequalae of traumatic injury that can complicate management of patients. The injury mechanism can introduce environmental spores into areas of the body normally not exposed to pathogens and this inoculation can progress rapidly to severe disease. The objective of this study was to present a case series of four trauma patients with invasive fungal infections that was used to develop an algorithm for work-up and treatment of these complex patients in future admissions. Four trauma patients who developed mucormycosis from two different hospitals are presented. One patient succumbed to their injuries whereas three were able to clear their infection with medical and surgical intervention. The surviving patients all had an infection of their lower extremity whereas the deceased patient had more extensive disease involving the thorax. Mucormycosis is a rare but significant post-trauma complication with substantial morbidity and mortality. Surgeons should be aware of this complication and maintain a high clinical suspicion because afflicted patients may not match the traditional clinical picture of a mucormycosis-susceptible patient. Close coordination with a pathology service is required for confirmation of the diagnosis and timely intervention can prevent debilitating loss of tissue or death. Additionally, consideration should be given to newer treatment modalities for management such as local tissue irrigation with an antifungal agent.
侵袭性真菌感染，最常见的病原体是 ，是创伤后未被充分认识的后遗症，可使创伤患者的治疗复杂化。损伤机制可将环境孢子引入通常不暴露于病原体的身体区域，这种接种可迅速进展为严重疾病。本研究的目的是报告 4 例创伤后侵袭性真菌感染患者的病例系列，用于为未来入院的这些复杂患者制定检查和治疗方案。
报告了来自两家不同医院的 4 例创伤后毛霉菌病患者。1 例患者因伤势过重而死亡，其余 3 例通过药物和手术干预清除了感染。存活的患者均下肢感染，而死亡的患者胸部感染更为广泛。毛霉菌病是一种罕见但严重的创伤后并发症，发病率和死亡率都很高。外科医生应该意识到这种并发症，并保持高度的临床怀疑，因为受累患者可能不符合毛霉菌病易感患者的传统临床特征。需要与病理科密切合作以确认诊断，及时干预可以防止组织严重丧失或死亡。此外，应考虑局部组织冲洗等新型治疗方法。
