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Mucormycosis in Burn Patients

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 case...

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Autores principales: Devauchelle, Pauline, Jeanne, Mathieu, Fréalle, Emilie
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6463177/
https://www.ncbi.nlm.nih.gov/pubmed/30901836
http://dx.doi.org/10.3390/jof5010025
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author Devauchelle, Pauline
Jeanne, Mathieu
Fréalle, Emilie
author_facet Devauchelle, Pauline
Jeanne, Mathieu
Fréalle, Emilie
author_sort Devauchelle, Pauline
collection PubMed
description 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.
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spelling pubmed-64631772019-04-17 Mucormycosis in Burn Patients Devauchelle, Pauline Jeanne, Mathieu Fréalle, Emilie J Fungi (Basel) Review 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. MDPI 2019-03-21 /pmc/articles/PMC6463177/ /pubmed/30901836 http://dx.doi.org/10.3390/jof5010025 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Devauchelle, Pauline
Jeanne, Mathieu
Fréalle, Emilie
Mucormycosis in Burn Patients
title Mucormycosis in Burn Patients
title_full Mucormycosis in Burn Patients
title_fullStr Mucormycosis in Burn Patients
title_full_unstemmed Mucormycosis in Burn Patients
title_short Mucormycosis in Burn Patients
title_sort mucormycosis in burn patients
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6463177/
https://www.ncbi.nlm.nih.gov/pubmed/30901836
http://dx.doi.org/10.3390/jof5010025
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