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Mucormycosis in Burn Patients.
J Fungi (Basel) 2019; 5(1)JF

Abstract

Patients with extensive burns are an important group at risk for cutaneous mucormycosis. This study aimed to perform a systematic review of all reported mucormycosis cases in burn patients from 1990 onward. A Medline search yielded identification of 7 case series, 3 outbreaks, and 25 individual cases reports. The prevalence reached 0.04%⁻0.6%. The median age was 42⁻48 in the case series and outbreaks, except for the studies from military centers (23.5⁻32.5) and in individual reports (29.5). The median total body surface area reached 42.5%⁻65%. Various skin lesions were described, none being pathognomonic: the diagnosis was mainly reached because of extensive necrotic lesions sometimes associated with sepsis. Most patients were treated with systemic amphotericin B or liposomal amphotericin B, and all underwent debridement and/or amputation. Mortality reached 33%⁻100% in the case series, 29%⁻62% during outbreaks, and 40% in individual cases. Most patients were diagnosed using histopathology and/or culture. Mucorales qPCR showed detection of circulating DNA 2⁻24 days before the standard diagnosis. Species included the main clinically relevant mucorales (i.e., Mucor, Rhizopus, Absidia/Lichtheimia, Rhizomucor) but also more uncommon mucorales such as Saksenaea or Apophysomyces. Contact with soil was reported in most individual cases. Bandages were identified as the source of contamination in two nosocomial outbreaks.

Authors+Show Affiliations

CHU Lille, Centre des Br슩lés, F-59000 Lille, France. pauline.clementgrandcourt@chru-lille.fr.CHU Lille, Centre des Br슩lés, F-59000 Lille, France. mathieu.jeanne@chru-lille.fr. Univ. Lille, Inserm, CHU Lille, CIC 1403-Centre d'Investigation Clinique, F-59000 Lille, France. mathieu.jeanne@chru-lille.fr.CHU Lille, Laboratoire de Parasitologie-Mycologie, F-59000 Lille, France. emilie.frealle@chru-lille.fr. Univ. Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, U1019⁻UMR8204-CIIL-Center for Infection and Immunity of Lille, F-59000 Lille, France. emilie.frealle@chru-lille.fr.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

30901836

Citation

Devauchelle, Pauline, et al. "Mucormycosis in Burn Patients." Journal of Fungi (Basel, Switzerland), vol. 5, no. 1, 2019.
Devauchelle P, Jeanne M, Fréalle E. Mucormycosis in Burn Patients. J Fungi (Basel). 2019;5(1).
Devauchelle, P., Jeanne, M., & Fréalle, E. (2019). Mucormycosis in Burn Patients. Journal of Fungi (Basel, Switzerland), 5(1), doi:10.3390/jof5010025.
Devauchelle P, Jeanne M, Fréalle E. Mucormycosis in Burn Patients. J Fungi (Basel). 2019 Mar 21;5(1) PubMed PMID: 30901836.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Mucormycosis in Burn Patients. AU - Devauchelle,Pauline, AU - Jeanne,Mathieu, AU - Fréalle,Emilie, Y1 - 2019/03/21/ PY - 2019/02/07/received PY - 2019/03/19/revised PY - 2019/03/20/accepted PY - 2019/3/24/entrez PY - 2019/3/25/pubmed PY - 2019/3/25/medline KW - Apophysomyces KW - Saksenaea KW - burn KW - cutaneous KW - environmental source KW - molecular typing KW - mucormycosis KW - nosocomial KW - outbreak KW - qPCR JF - Journal of fungi (Basel, Switzerland) JO - J Fungi (Basel) VL - 5 IS - 1 N2 - Patients with extensive burns are an important group at risk for cutaneous mucormycosis. This study aimed to perform a systematic review of all reported mucormycosis cases in burn patients from 1990 onward. A Medline search yielded identification of 7 case series, 3 outbreaks, and 25 individual cases reports. The prevalence reached 0.04%⁻0.6%. The median age was 42⁻48 in the case series and outbreaks, except for the studies from military centers (23.5⁻32.5) and in individual reports (29.5). The median total body surface area reached 42.5%⁻65%. Various skin lesions were described, none being pathognomonic: the diagnosis was mainly reached because of extensive necrotic lesions sometimes associated with sepsis. Most patients were treated with systemic amphotericin B or liposomal amphotericin B, and all underwent debridement and/or amputation. Mortality reached 33%⁻100% in the case series, 29%⁻62% during outbreaks, and 40% in individual cases. Most patients were diagnosed using histopathology and/or culture. Mucorales qPCR showed detection of circulating DNA 2⁻24 days before the standard diagnosis. Species included the main clinically relevant mucorales (i.e., Mucor, Rhizopus, Absidia/Lichtheimia, Rhizomucor) but also more uncommon mucorales such as Saksenaea or Apophysomyces. Contact with soil was reported in most individual cases. Bandages were identified as the source of contamination in two nosocomial outbreaks. SN - 2309-608X UR - https://www.unboundmedicine.com/medline/citation/30901836/Mucormycosis_in_Burn_Patients L2 - http://www.mdpi.com/resolver?pii=jof5010025 DB - PRIME DP - Unbound Medicine ER -