Mucorales-disseminated infection in burn wound

Author:

Herbst IsabellaORCID,Helleberg Marie,Overgaard-Steensen Christian,Holmgaard Rikke

Abstract

A previously fit and well man in his 50s was rescued from a burning apartment with Glasgow Coma Scale 3 and admitted to the burn intensive care unit with 18% mixed dermal and full thickness burns and inhalation injury. He received standardised acute burn treatment according to the Emergency Management of Severe Burn guidelines and was found to have acute kidney injury requiring dialysis and cerebral watershed infarcts. The burns were deep especially on the left leg that was deemed unsalvageable and on day 8, he underwent a mid-femoral amputation.A wound swab on day 8 grew mould and with progression of skin necrosis,Mucoralesinfection was clinically suspected. Microbiological assessment of the swab confirmedMucoralesinfection—an invasive fungus with the ability to invade blood vessels leading to vessel thrombosis and tissue necrosis and associated with high mortality. Recommended radical debridement with free cutaneous margins was not possible due to the widespread disease, and the patient was treated conservatively with antifungal therapy and survived.

Publisher

BMJ

Subject

General Medicine

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