Bilal Zahoor1, Stephen Kent2, Daryl Wall3. 1. Department of Trauma, Royal Brisbane and Women's Hospital, Brisbane, QLD AU 4005, Australia; School of Medicine, University of Queensland, Brisbane, QLD AU 4005, Australia; School of Public Health, Johns Hopkins University, Baltimore, MD 21231, USA. Electronic address: bilal.zahoor@uqconnect.edu.au. 2. Department of Orthopaedics, Royal Brisbane and Women's Hospital, Brisbane, QLD AU 4005, Australia. 3. Department of Trauma, Royal Brisbane and Women's Hospital, Brisbane, QLD AU 4005, Australia; School of Medicine, University of Queensland, Brisbane, QLD AU 4005, Australia.
Abstract
INTRODUCTION: Mucormycosis is a rare but serious sequelae of penetrating trauma [1-5]. In spite of aggressive management, mortality remains high due to dissemination of infection. We completed a review of literature to determine the most optimal treatment of cutaneous mucormycosis which occurs secondary to penetrating trauma. METHODS: We completed a review regarding the management of mucormycosis in trauma patients. We selected a total of 36 reports, of which 18 were case-based, for review. RESULTS: Surgical debridement is a primary predictor of improved outcomes in the treatment of mucormycosis [3,6,7]. Anti-fungal therapy, especially lipid soluble formulation of Amphotericin B, is helpful as an adjunct or when surgical debridement has been maximally achieved. Further research is needed to fully evaluate the impact of topical dressings; negative pressure wound therapy is helpful. CONCLUSION: An aggressive and early surgical approach, even at the expense of disfigurement, is necessary to reduce mortality in the setting of cutaneous mucormycosis that results from penetrating trauma [4,8,9]. Anti-fungal therapy and negative pressure wound therapy are formidable adjuncts.
INTRODUCTION:Mucormycosis is a rare but serious sequelae of penetrating trauma [1-5]. In spite of aggressive management, mortality remains high due to dissemination of infection. We completed a review of literature to determine the most optimal treatment of cutaneous mucormycosis which occurs secondary to penetrating trauma. METHODS: We completed a review regarding the management of mucormycosis in traumapatients. We selected a total of 36 reports, of which 18 were case-based, for review. RESULTS: Surgical debridement is a primary predictor of improved outcomes in the treatment of mucormycosis [3,6,7]. Anti-fungal therapy, especially lipid soluble formulation of Amphotericin B, is helpful as an adjunct or when surgical debridement has been maximally achieved. Further research is needed to fully evaluate the impact of topical dressings; negative pressure wound therapy is helpful. CONCLUSION: An aggressive and early surgical approach, even at the expense of disfigurement, is necessary to reduce mortality in the setting of cutaneous mucormycosis that results from penetrating trauma [4,8,9]. Anti-fungal therapy and negative pressure wound therapy are formidable adjuncts.
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