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A Clinical-Pathologic Review

MAJ Harold M. Bruck, MC, USA; MAJ Gerald Nash, MC, USA; F. Daniel Foley, MD; LTC Basil A. Pruitt, Jr., MC, USA

AMA Arch Surg. 1971;102(5):476-482.

Abstract
Thirty cases of invasive infection of the burn wound with opportunistic fungi of the Phycomycetes and Aspergillus species occurred. Mycotic invasion of the burn wound has a wide clinical spectrum including focal and multifocal infection, deep invasion with extensive tissue destruction, and systemic dissemination. Nine patients (30%) died from fungal invasion. Of 15 survivors, seven (46.7%) required amputation to eradicate disease. Prompt, adequate biopsy of any suspicious area of the burn wound must be processed immediately. The observation of hyphae invading viable tissue associated with an acute inflammatory response establishes the diagnosis. Immediate wide surgical excision, which may include amputation, is necessary to eradicate this potentially lethal infection.

Author Affiliations
Fort Sam Houston, Tex

From the US Army Institute of Surgical Research, Brooke Army Medical Center, Fort Sam Houston, Tex.

Footnotes
Accepted for publication Dec 7, 1970.

Reprint requests to US Army Institute of Surgical Research, Brooke Army Medical Center, Fort Sam Houston, Tex 78234 (Dr. Bruck).

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