Combat trauma-related invasive fungal wound infections.

IF 2.3 Q3 INFECTIOUS DISEASES

Current Fungal Infection Reports Pub Date : 2020-06-01 Epub Date: 2020-04-16 DOI:10.1007/s12281-020-00385-4

David R Tribble, Anuradha Ganesan, Carlos J Rodriguez

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引用次数: 8

Abstract

Purpose of review: This review highlights research from the past five years on combat trauma-related invasive fungal wound infections (IFIs) with a focus on risk stratification to aid patient management, microbiology, and diagnostics.

Recent findings: A revised classification scheme stratifies wounds into three risk groups: IFI, High Suspicion of IFI, and Low Suspicion of IFI. This stratification is based on persistence of wound necrosis and laboratory fungal evidence, presence of signs/symptoms of deep soft-tissue infections, and the need for antifungals. Use of this classification could allow for prioritization of antifungal therapy. Further, IFIs delay wound healing, particularly when caused by fungi of the order Mucorales. Lastly, molecular sequencing offers promising and complimentary results to the gold standard histopathology.

Summary: Optimal management of combat-related IFIs depends on early tissue-based diagnosis with aggressive surgical debridement and concomitant dual antifungal therapy. Further research on clinical decision support tools and rapid diagnostics are needed.

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对抗创伤相关的侵袭性真菌伤口感染。

综述目的:本综述重点介绍了过去五年来在战斗创伤相关侵袭性真菌伤口感染(IFIs)方面的研究，重点是风险分层，以帮助患者管理、微生物学和诊断。最新发现:修订后的分类方案将伤口分为三个风险组:IFI、高怀疑IFI和低怀疑IFI。这种分层是基于伤口坏死的持续性和实验室真菌证据、深部软组织感染的体征/症状的存在以及抗真菌药物的需要。使用这种分类可以优先考虑抗真菌治疗。此外，国际金融机构延缓伤口愈合，特别是由毛霉菌引起的伤口愈合。最后，分子测序为金标准组织病理学提供了有希望的和互补的结果。摘要:战斗相关IFIs的最佳治疗取决于早期组织诊断，积极的手术清创和双重抗真菌治疗。需要进一步研究临床决策支持工具和快速诊断。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Fungal Infection Reports INFECTIOUS DISEASES-

CiteScore

3.10

自引率

7.10%

发文量

期刊介绍： This journal intends to provide clear, insightful, balanced contributions that review the most important, recently published clinical findings related to the diagnosis, treatment, management, and prevention of fungal infections. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as advances in diagnosis, current and emerging management approaches, and genomics and pathogenesis. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. Commentaries from well-known figures in the field are also provided, and an international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research.