Classification of trauma-associated invasive fungal infections to support wound treatment decisions

Infectious Disease Clinical Research Program Trauma Infectious Disease Outcomes Study Group

Research output: Contribution to journalArticlepeer-review

14 Scopus citations


To evaluate a classification system to support clinical decisions for treatment of contaminated deep wounds at risk for an invasive fungal infection (IFI), we studied 246 US service members (413 wounds) injured in Afghanistan (2009-2014) who had laboratory evidence of fungal infection. A total of 143 wounds with persistent necrosis and laboratory evidence were classified as IFI; 120 wounds not meeting IFI criteria were classified as high suspicion (patients had localized infection signs/symptoms and had received antifungal medication for ≥10 days), and 150 were classified as low suspicion (failed to meet these criteria). IFI patients received more blood than other patients and had more severe injuries than patients in the low-suspicion group. Fungi of the order Mucorales were more frequently isolated from IFI (39%) and high-suspicion (21%) wounds than from low-suspicion (9%) wounds. Wounds that did not require immediate antifungal therapy lacked necrosis and localized signs/symptoms of infection and contained fungi from orders other than Mucorales.

Original languageEnglish
Pages (from-to)1639-1647
Number of pages9
JournalEmerging Infectious Diseases
Issue number9
StatePublished - 2019
Externally publishedYes


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