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Trichoderma longibrachiatum and Aspergillus fischeri Infection as a Cause of Skin Graft Failure in a Patient with Critical Burns after Liver Transplantation

Infectious complications are responsible for the majority of mortalities and morbidities of patients with critical burns. Although bacteria are the predominant etiological agents in such patients, yeasts and fungi have become relatively common causes of infections over the last decade. Here, we repo...

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Autores principales: Lipový, Břetislav, Raška, Filip, Kocmanová, Iva, Hanslianová, Markéta, Hladík, Martin, Holoubek, Jakub, Bezdíček, Matěj, Macháček, Ctirad
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8234584/
https://www.ncbi.nlm.nih.gov/pubmed/34207136
http://dx.doi.org/10.3390/jof7060487
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author Lipový, Břetislav
Raška, Filip
Kocmanová, Iva
Hanslianová, Markéta
Hladík, Martin
Holoubek, Jakub
Bezdíček, Matěj
Macháček, Ctirad
author_facet Lipový, Břetislav
Raška, Filip
Kocmanová, Iva
Hanslianová, Markéta
Hladík, Martin
Holoubek, Jakub
Bezdíček, Matěj
Macháček, Ctirad
author_sort Lipový, Břetislav
collection PubMed
description Infectious complications are responsible for the majority of mortalities and morbidities of patients with critical burns. Although bacteria are the predominant etiological agents in such patients, yeasts and fungi have become relatively common causes of infections over the last decade. Here, we report a case of a young man with critical burns on 88% TBSA (total body surface area) arising as a part of polytrauma. The patient’s history of orthotopic liver transplantation associated with the patient’s need to use combined immunosuppressant therapy was an additional complication. Due to deep burns in the forearm region, we have (after a suitable wound bed preparation) applied a new bi-layered dermal substitute. The patient, however, developed a combined fungal infection in the region of this dermal substitute caused by Trichoderma longibrachiatum and Aspergillus fischeri (the first case ever reported). The infection caused the loss of the split-thickness skin grafts (STSGs); we had to perform repeated hydrosurgical and mechanical debridement and a systemic antifungal treatment prior to re-application of the STSGs. The subsequent skin transplant was successful.
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spelling pubmed-82345842021-06-27 Trichoderma longibrachiatum and Aspergillus fischeri Infection as a Cause of Skin Graft Failure in a Patient with Critical Burns after Liver Transplantation Lipový, Břetislav Raška, Filip Kocmanová, Iva Hanslianová, Markéta Hladík, Martin Holoubek, Jakub Bezdíček, Matěj Macháček, Ctirad J Fungi (Basel) Case Report Infectious complications are responsible for the majority of mortalities and morbidities of patients with critical burns. Although bacteria are the predominant etiological agents in such patients, yeasts and fungi have become relatively common causes of infections over the last decade. Here, we report a case of a young man with critical burns on 88% TBSA (total body surface area) arising as a part of polytrauma. The patient’s history of orthotopic liver transplantation associated with the patient’s need to use combined immunosuppressant therapy was an additional complication. Due to deep burns in the forearm region, we have (after a suitable wound bed preparation) applied a new bi-layered dermal substitute. The patient, however, developed a combined fungal infection in the region of this dermal substitute caused by Trichoderma longibrachiatum and Aspergillus fischeri (the first case ever reported). The infection caused the loss of the split-thickness skin grafts (STSGs); we had to perform repeated hydrosurgical and mechanical debridement and a systemic antifungal treatment prior to re-application of the STSGs. The subsequent skin transplant was successful. MDPI 2021-06-18 /pmc/articles/PMC8234584/ /pubmed/34207136 http://dx.doi.org/10.3390/jof7060487 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/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 (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Lipový, Břetislav
Raška, Filip
Kocmanová, Iva
Hanslianová, Markéta
Hladík, Martin
Holoubek, Jakub
Bezdíček, Matěj
Macháček, Ctirad
Trichoderma longibrachiatum and Aspergillus fischeri Infection as a Cause of Skin Graft Failure in a Patient with Critical Burns after Liver Transplantation
title Trichoderma longibrachiatum and Aspergillus fischeri Infection as a Cause of Skin Graft Failure in a Patient with Critical Burns after Liver Transplantation
title_full Trichoderma longibrachiatum and Aspergillus fischeri Infection as a Cause of Skin Graft Failure in a Patient with Critical Burns after Liver Transplantation
title_fullStr Trichoderma longibrachiatum and Aspergillus fischeri Infection as a Cause of Skin Graft Failure in a Patient with Critical Burns after Liver Transplantation
title_full_unstemmed Trichoderma longibrachiatum and Aspergillus fischeri Infection as a Cause of Skin Graft Failure in a Patient with Critical Burns after Liver Transplantation
title_short Trichoderma longibrachiatum and Aspergillus fischeri Infection as a Cause of Skin Graft Failure in a Patient with Critical Burns after Liver Transplantation
title_sort trichoderma longibrachiatum and aspergillus fischeri infection as a cause of skin graft failure in a patient with critical burns after liver transplantation
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8234584/
https://www.ncbi.nlm.nih.gov/pubmed/34207136
http://dx.doi.org/10.3390/jof7060487
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