Humicola Trauma-related Invasive Fungal Infection in an Immunocompetent Patient

Author:

Gonte Madeleine R.123,Ranganathan Kavitha L.45,Helliwell Lydia A.45

Affiliation:

1. Harvard T.H. Chan School of Public Health, Boston, Mass.

2. Brigham and Women’s Hospital, Boston, Mass.

3. Wayne State University School of Medicine, Detroit, Mich.

4. Department of Plastic and Reconstructive Surgery, Brigham and Women’s Hospital, Boston, Mass.

5. Harvard Medical School, Boston, Mass.

Abstract

Summary: The majority of invasive fungal infections arise in immunocompromised patients; however, there exist many clinical interventions and physiologic phenomena in the setting of traumatic injury that induce immunosuppressant states. Enhanced clinical suspicion and early detection of invasive fungal infections has played an increasingly pertinent role in clinical management of patients admitted for traumatic injury, given its substantial morbidity and mortality rates. In this case report, we discuss a case of trauma-related invasive fungal infection by a rare humicola pathogen in a previously immunocompetent patient. We present this case in hopes of instilling a high index of clinical suspicion for trauma-related invasive fungal infections. We also discuss the role of negative pressure wound therapy and aggressive surgical management, including debridement and various levels of amputation to optimize patient outcomes. Clinical management of trauma-related IFI has adopted increasingly aggressive approaches with respect to its formidable morbidity and mortality rates. Multidisciplinary discussions and patient-centered care are essential when making surgical decisions that impact quality of life such as amputation level.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Surgery,General Medicine

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