Fungal sepsis: an increasing problem in major thermal injuries

• Published in: Journal of burn care & rehabilitation Vol. 7; no. 6; p. 488
• Main Authors: Pensler, J M, Herndon, D N, Ptak, H, Bonds, E, Rutan, T C, Desai, M H, Abston, S
• Format: Journal Article
• Language: English
• Published: United States 01.11.1986
• Subjects: Adolescent; Amphotericin B - therapeutic use; Burns - complications; Debridement; Humans; Mycoses - etiology; Mycoses - mortality; Mycoses - therapy; Wound Infection - etiology; Wound Infection - mortality; Wound Infection - therapy
• ISSN: 0273-8481
• DOI: 10.1097/00004630-198611000-00008

In major thermal burns there has been an alarming emergence of fungal sepsis as defined by involvement of three or more organs and/or repeated positive blood cultures. During an 18-month period, we treated 72 patients (aged 18 +/- 2 years; TBSA burn, 57 +/- 3%; percent of third-degree burn, 45 +/- 3) with fungal sepsis. In all patients with documented three-organ involvement, treatment was with intravenous amphotericin (0.5 mg/kg body weight/day), immediate wound debridement, and early wound closure. The mortality was 32% (23 patients); 49 (68%) survived infection. Sixty-two variables were reviewed retrospectively using multiple regression analysis to ascertain specific factors associated with fungal sepsis and their relationship to survival. In burn patients, fungal sepsis is a strong determinant of survival, and its occurrence overshadows traditional factors presently utilized to predict clinical outcome.