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Invasive Mykosen und Trauma

Invasive mycoses and trauma

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Summary

Perforating injury allows the dispersion of environmental fungi and fungal spores together with miniscule foreign bodies into traumatized tissue where they can multiply and cause invasive infection. Acute invasive fungal infection after open fractures is uncommon. The severity of the fungal infections depends on the type of injury (perforating, presence of foreign material), the body area and the general condition of the patient. Fungal infections of the immuncompetent host are generally localized within the dermis, invasion of the fascia, muscles and the bone is rare. Injury-related fungal infections of the immuncompromised host may lead to rapid invasion and generalization of the fungal infection. The following review will focus on the fungal infections after perforating injuries and open fractures including the invasive mycoses as a direct consequence of the trauma, post-traumatic fungal infections, tropical fungal infections (mycetoma), invasive fungal infections after near-drowning and nosocomial invasive fungal infections of the critically ill post-traumatic patient admitted to the intensive care unit.

Zusammenfassung

Das eingesprengte Fremdmaterial bei einer offenen Verletzung begünstigt die Inokulation ubiquitär vorhandener Pilze, die in traumatisch verändertem Gewebe sich festsetzen und vermehren können. Akut verlaufende Pilzinfektionen infolge eines perforierenden Traumas sind sehr selten. Die Schwere der Infektion ist von der Art der Verletzung (penetrierend, Fremdkörper), der Körperregion und vom Allgemeinzustand des Patienten abhängig. Bei immunkompetenten Patienten bleibt die Infektion lokal auf Kutis und Subkutis beschränkt, seltener sind Faszien, Muskeln und Knochen betroffen. Diese Übersichtsarbeit befasst sich mit Pilzinfektionen nach offenen Verletzungen. Die invasiven Pilzinfektionen werden in folgende Gruppen eingeteilt: invasive Mykosen durch Inokulation als direkte Verletzungsfolge, nach Augenverletzungen, als tropische Pilzerkrankung (Myzetom, Madurafuss), nach (Beinahe-)Ertrinken und invasive Mykosen als nosokomiale Infektion bei Langzeitaufenthalt auf Intensivstationen nach schwerem Polytrauma.

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Authors and Affiliations

  1. Universitätsklinik für Unfallchirurgie, Medizinische Universität Wien, Wien, Austria

    Alexandra Obradovic & Stefan Hajdu

  2. Klinische Abteilung für Infektionen und Tropenmedizin, Universitätsklinik für Innere Medizin I, Medizinische Universität Wien, Wien, Austria

    Elisabeth Presterl

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  1. Alexandra Obradovic
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  2. Stefan Hajdu
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  3. Elisabeth Presterl
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Correspondence to Elisabeth Presterl.

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Obradovic, A., Hajdu, S. & Presterl, E. Invasive Mykosen und Trauma. Wien Med Wochenschr 157, 482–489 (2007). https://doi.org/10.1007/s10354-007-0463-1

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