Candida infection in massively burned patients

M. H. Desai, David Herndon, S. Abston

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Immunosuppressed burned patients receiving antibiotics for suppression of bacterial infection are ideal hosts for opportunistic fungi. Massive excision of burns with autograft and homograft coverage has radically changed the course of disease. Three hundred ninety-three patients were admitted to the Shriners Burns Institute, of whom 125 patients had fungus cultured during their hospitalization and 42 patients subsequently developed involvement of three or more organs. Twenty-one of the 42 patients developed Candida septicemia requiring amphotericin B or flucytosine therapy. The mean third-degree burn in patients with Candida septicemia was 65% total body surface area compared to three-organ involvement/no clinical sepsis at 38% mean third-degree burn. Patients developing candidemia did so during the first week postburn and 7 days after excision therapy. It is hypothesized that massive burns with immunosuppression are further suppressed by repeated surgical intervention, anesthesia, and perioperative use of broad-spectrum antibiotics, further predisposing these patients to early development of Candida septicemia. With early recognition of burn wound invasion by routine biopsies, wound swabs, and early amphotericin therapy, the mortality has been reduced to 14% compared to 60-90% reported in other series.

Original languageEnglish (US)
Pages (from-to)1186-1188
Number of pages3
JournalJournal of Trauma
Volume27
Issue number10
StatePublished - 1987

Fingerprint

Candida
Infection
Sepsis
Burns
Amphotericin B
Fungi
Candidemia
Anti-Bacterial Agents
Flucytosine
Body Surface Area
Autografts
Wounds and Injuries
Secondary Prevention
Bacterial Infections
Immunosuppression
Allografts
Hospitalization
Anesthesia
Biopsy
Mortality

ASJC Scopus subject areas

  • Surgery

Cite this

Desai, M. H., Herndon, D., & Abston, S. (1987). Candida infection in massively burned patients. Journal of Trauma, 27(10), 1186-1188.

Candida infection in massively burned patients. / Desai, M. H.; Herndon, David; Abston, S.

In: Journal of Trauma, Vol. 27, No. 10, 1987, p. 1186-1188.

Research output: Contribution to journalArticle

Desai, MH, Herndon, D & Abston, S 1987, 'Candida infection in massively burned patients', Journal of Trauma, vol. 27, no. 10, pp. 1186-1188.
Desai MH, Herndon D, Abston S. Candida infection in massively burned patients. Journal of Trauma. 1987;27(10):1186-1188.
Desai, M. H. ; Herndon, David ; Abston, S. / Candida infection in massively burned patients. In: Journal of Trauma. 1987 ; Vol. 27, No. 10. pp. 1186-1188.
@article{3b7f63c04b5c4267992fa3c0d2aeea80,
title = "Candida infection in massively burned patients",
abstract = "Immunosuppressed burned patients receiving antibiotics for suppression of bacterial infection are ideal hosts for opportunistic fungi. Massive excision of burns with autograft and homograft coverage has radically changed the course of disease. Three hundred ninety-three patients were admitted to the Shriners Burns Institute, of whom 125 patients had fungus cultured during their hospitalization and 42 patients subsequently developed involvement of three or more organs. Twenty-one of the 42 patients developed Candida septicemia requiring amphotericin B or flucytosine therapy. The mean third-degree burn in patients with Candida septicemia was 65{\%} total body surface area compared to three-organ involvement/no clinical sepsis at 38{\%} mean third-degree burn. Patients developing candidemia did so during the first week postburn and 7 days after excision therapy. It is hypothesized that massive burns with immunosuppression are further suppressed by repeated surgical intervention, anesthesia, and perioperative use of broad-spectrum antibiotics, further predisposing these patients to early development of Candida septicemia. With early recognition of burn wound invasion by routine biopsies, wound swabs, and early amphotericin therapy, the mortality has been reduced to 14{\%} compared to 60-90{\%} reported in other series.",
author = "Desai, {M. H.} and David Herndon and S. Abston",
year = "1987",
language = "English (US)",
volume = "27",
pages = "1186--1188",
journal = "Journal of Trauma and Acute Care Surgery",
issn = "2163-0755",
publisher = "Lippincott Williams and Wilkins",
number = "10",

}

TY - JOUR

T1 - Candida infection in massively burned patients

AU - Desai, M. H.

AU - Herndon, David

AU - Abston, S.

PY - 1987

Y1 - 1987

N2 - Immunosuppressed burned patients receiving antibiotics for suppression of bacterial infection are ideal hosts for opportunistic fungi. Massive excision of burns with autograft and homograft coverage has radically changed the course of disease. Three hundred ninety-three patients were admitted to the Shriners Burns Institute, of whom 125 patients had fungus cultured during their hospitalization and 42 patients subsequently developed involvement of three or more organs. Twenty-one of the 42 patients developed Candida septicemia requiring amphotericin B or flucytosine therapy. The mean third-degree burn in patients with Candida septicemia was 65% total body surface area compared to three-organ involvement/no clinical sepsis at 38% mean third-degree burn. Patients developing candidemia did so during the first week postburn and 7 days after excision therapy. It is hypothesized that massive burns with immunosuppression are further suppressed by repeated surgical intervention, anesthesia, and perioperative use of broad-spectrum antibiotics, further predisposing these patients to early development of Candida septicemia. With early recognition of burn wound invasion by routine biopsies, wound swabs, and early amphotericin therapy, the mortality has been reduced to 14% compared to 60-90% reported in other series.

AB - Immunosuppressed burned patients receiving antibiotics for suppression of bacterial infection are ideal hosts for opportunistic fungi. Massive excision of burns with autograft and homograft coverage has radically changed the course of disease. Three hundred ninety-three patients were admitted to the Shriners Burns Institute, of whom 125 patients had fungus cultured during their hospitalization and 42 patients subsequently developed involvement of three or more organs. Twenty-one of the 42 patients developed Candida septicemia requiring amphotericin B or flucytosine therapy. The mean third-degree burn in patients with Candida septicemia was 65% total body surface area compared to three-organ involvement/no clinical sepsis at 38% mean third-degree burn. Patients developing candidemia did so during the first week postburn and 7 days after excision therapy. It is hypothesized that massive burns with immunosuppression are further suppressed by repeated surgical intervention, anesthesia, and perioperative use of broad-spectrum antibiotics, further predisposing these patients to early development of Candida septicemia. With early recognition of burn wound invasion by routine biopsies, wound swabs, and early amphotericin therapy, the mortality has been reduced to 14% compared to 60-90% reported in other series.

UR - http://www.scopus.com/inward/record.url?scp=0023472482&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0023472482&partnerID=8YFLogxK

M3 - Article

C2 - 3669112

AN - SCOPUS:0023472482

VL - 27

SP - 1186

EP - 1188

JO - Journal of Trauma and Acute Care Surgery

JF - Journal of Trauma and Acute Care Surgery

SN - 2163-0755

IS - 10

ER -