Improved survival with aggressive surgical management of noncandidal fungal infections of the burn wound.

A period of aggressive surgical treatment of early identification of fungal infection of the burn wound was compared with the previous 5 years' experience with patients suffering from fungal infection of burn wounds. The portion of those patients with Candida infections diagnosed and treated premortem increased from 48.0% to 63.6% and of patients with noncandidal infections from 40.8% to 67.0% in the more recent period. The mortality of patients with Candida infections in 1973 to 1977 was 83.3% and in 1978 was 87.5%. The mortality of noncandidal infections, 87.4% in 1973 to 1977, was 25.0% in 1978. Local surgical control of the infected portion of burn wounds is an effective way of improving the survival in noncandidal burn wound infections. Surgical excision of burn wounds does not alter the poor prognosis of patients with Candida invasion of the burn wound.