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Mucormycosis following burn injuries: A systematic review.
Dang, Justin; Goel, Pedram; Choi, Katherine J; Massenzio, Erik; Landau, Mark J; Pham, Christopher H; Huang, Samantha; Yenikomshian, Haig A; Spellberg, Brad; Gillenwater, T Justin.
Afiliación
  • Dang J; Division of Plastic and Reconstructive Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States; Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, United States.
  • Goel P; Keck School of Medicine, University of Southern California, Los Angeles, CA, United States.
  • Choi KJ; Keck School of Medicine, University of Southern California, Los Angeles, CA, United States.
  • Massenzio E; Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, United States.
  • Landau MJ; Keck School of Medicine, University of Southern California, Los Angeles, CA, United States.
  • Pham CH; Division of Plastic and Reconstructive Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States.
  • Huang S; Keck School of Medicine, University of Southern California, Los Angeles, CA, United States.
  • Yenikomshian HA; Division of Plastic and Reconstructive Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States; Los Angeles County + University of Southern California (LAC+USC) Medical Center, Los Angeles, CA, United States.
  • Spellberg B; Los Angeles County + University of Southern California (LAC+USC) Medical Center, Los Angeles, CA, United States; Division of Infectious Diseases, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States.
  • Gillenwater TJ; Division of Plastic and Reconstructive Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States; Los Angeles County + University of Southern California (LAC+USC) Medical Center, Los Angeles, CA, United States. Electronic address: justin.gillenwater@med.usc.
Burns ; 49(1): 15-25, 2023 02.
Article en En | MEDLINE | ID: mdl-35842270
INTRODUCTION: Mucormycosis is an opportunistic fungal infection with a high mortality rate. Though typically associated with diabetes and other conditions that affect innate immune function, infections can also be precipitated by conditions such as trauma and burns. Burn patients are particularly susceptible to fungal infections due to the immune dysfunction that often accompany their wounds. Indeed case series have described mucormycosis to occur in patients with burn injuries, however the factors contributing to mortality have not been well described. Thus, the purpose of our review was to identify factors contributing to morbidity and mortality in burn patients with Mucormycosis. METHODS: A systematic review of the literature of mucormycosis infection in burn injury patients was performed on Pubmed and Google Scholar using the keywords: Mucor, Mucorales, Mucormycosis, Mucormycotina, Zygomycosis and burn or thermal injury. Clinical trials, observational studies, case reports, and case reviews were included if they provided information regarding mortality in adult and pediatric burn patients diagnosed with mucormycosis, review articles, non-English articles, and articles without patient information were excluded. No time limit was placed on our review. Individual patient data was stratified based on mortality. Statistical analysis was performed to investigate the relationship between patient risk factors and mortality, and the Oxford Level of Evidence was used to evaluate study quality. RESULTS: 46 articles were included in our final review, encompassing 114 patients. On average, survivors had a total body surface area (TBSA)% of 46 (SD 19.8) while non-survivors had a TBSA of 65% (SD 16.4), and this difference was significant (p < .001). Patients with disseminated mucormycosis experienced an 80% mortality rate compared to 36% mortality rate in patients with localized disease (p < .001). We found no statistically significant difference in mean age (p > .05), diabetes (p > .05), mean delay in diagnosis (p > .05), time to antifungal therapy (p > .05), or type of therapy used (p > .05) between survivors and non-survivors. Our review was limited by the lack of prospective, controlled trials; thus, our review primarily consists of case reports. CONCLUSION: Disseminated infections and higher TBSA both increased the risk of mortality in burn patients with mucormycosis, while diabetes did not increase mortality risk. The severity of the initial injury and infection locations must be taken into consideration to inform patient prognosis.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Quemaduras / Mucormicosis Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies / Systematic_reviews Límite: Adult / Child / Humans Idioma: En Revista: Burns Asunto de la revista: TRAUMATOLOGIA Año: 2023 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Países Bajos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Quemaduras / Mucormicosis Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies / Systematic_reviews Límite: Adult / Child / Humans Idioma: En Revista: Burns Asunto de la revista: TRAUMATOLOGIA Año: 2023 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Países Bajos