The burn wound represents a susceptible site for opportunistic colonization by organisms of endogenous and exogenous origin. Fungal wound infection is a leading cause of burn wound infections. Most of the fungal infections are missed owing to lack of clinical awareness and similar presentation as bacterial infection coupled with paucity of mycology laboratories. Expedient diagnosis and treatment of these mycoses can be life-saving as the mortality is otherwise very high.
Objective: To study the incidence and type of fungal infection in burn patient and to evaluate its role in morbidity and mortality of burn patients.
Method: This was an institution-based, prospective, non-randomized study. Skin swabs were collected from 50 patients who were admitted under department surgery with >15% burn surface area. Patients below 18 years and those with any systemic comorbidities were excluded.
Results: Of total 50 patients 28 cases (56%) were positive for fungal elements, total negative cases were 22. GMS stain and 10% KOH stain (Smear test) were positive in 25 patients and culture was positive in 23 cases out of 56% of total positive cases, 33.33% were in 15-29% TBSA group, 66.7% were in 30-59% TBSA group and 78.6% were in 60% or above TBSA group. This showed a clear increase in fungal positive cases with increase of total body surface area involvement. Candida fungi were seen in the greatest fraction of patients (60.7%), Mucor-like in the smallest fraction (7%), and Aspergillus-like in an intermediate fraction (21.4%). There was higher observed mortality with deeper fungal involvement.
Conclusion: This study showed that fungal infection influenced mortality and morbidity of burn patients. Also mortality due to fungal infection in these patients was significantly associated with Total body surface area (TBSA %) of burn and age of patient.