• Objective of the study
There is a higher rate of survival in patients suffering from complex extremity trauma due to advances in medical care. As a result of this, there is an increase in the recognition of surviving patients suffering from rare invasive fungal wound infections (IFIs). IFIs of the skin and soft tissue caused by gross contaminations may lead to further health complications. Additional understandings of the risk factors involved with this infection are required in order to reduce the morbidity rates of patients suffering from IFIs. In order to fulfill this need; the Infectious Disease Clinical Research Program Trauma Infectious Disease Outcome Study Group documented the IFI epidemiology, clinical findings, and laboratory findings through studying the injuries of US military personnel.
2413 US military personnel who were injured in combat in Afghanistan from June 2009 through December 2010 who were evacuated through Landstuhl Regional Medical Center (LRMC) and transferred to 1 of 3 different US military hospitals mentioned in the journal were subjected to this study. The various data used in this study were obtained through trauma registry (JTTR), and the review of histopathology specimens by 2 surgical pathologists. Using the guidelines set by the Mycosis Study Group, patients were diagnosed based on four criterions:
1. Traumatic wounds
2. After ≥ 1irrigation and debridements
3. Tissue necrosis on ≥ 2 consecutive debridements
4. IFI evidence
Using the results from the diagnosis, patients were either classified as proven IFI, probable IFI, or possible IFI.
• The findings
Of the 37 patients diagnosed with IFI during the period of study; 20 were proven, 4 were probable, and 13 were possible cases. All patients diagnosed with IFI were males with a median age of 23 years. All of the injuries were secondary to explosive blasts. Most of the patients suffered from extremity injuries during foot patrol in southern Afghanistan and received initial care, with 29 personnel receiving amputation at the time of injury. It should also be noted that the rate of IFI cases among injured personnel progressively increased during the period of study, reaching a maximum of 3.5% of trauma admissions in Q4 of 2010. In most cases, patients...