Invasive fungal infections following combat-related injury

Kristopher M. Paolino, James A. Henry, Duane R. Hospenthal, Glenn W. Wortmann, Joshua D. Hartzell

Research output: Contribution to journalArticlepeer-review

41 Scopus citations

Abstract

Invasive mold infections are a rare complication of traumatic wounds. We examined the incidence and outcomes of these infections in combat wounds. A retrospective chart review from March 2002 through July 2008 of U.S. soldiers returning from Iraq and Afghanistan with traumatic wounds was performed. A confirmed fungal wound infection was defined as growth of a known pathogenic mold and visualization of fungal elements on histopathology. Six cases were identified for an incidence of 0.4 cases/1,000 admissions. The incidence of invasive mold infections increased over time (p = 0.008) with a peak of 5.2 cases/1,000 admissions in 2007. Isolated molds included Aspergillus (n = 4), Bipolaris (n = 2), and 1 each Mucor and Absidia. All patients were male with a mean age of 22. Blast (n = 5) and gunshot wound (n = 1) were the sources of injury. All patients had fever (mean 39.4 °C) and leukocytosis (mean white blood cell count 25 + 103/mL). The average acute physiology and chronic health evaluation II score was 22. All patients received antifungal agents, surgical debridement, and 3 required amputation revision. Average length of stay was 97 days. There were no deaths. Invasive mold infections are a rare complication of combat wounds but are associated with significant morbidity and may be increasing in frequency.

Original languageEnglish
Pages (from-to)681-685
Number of pages5
JournalMilitary Medicine
Volume177
Issue number6
DOIs
StatePublished - Jun 2012
Externally publishedYes

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