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Volume 21, Number 10—October 2015
Research

Environmental Factors Related to Fungal Wound Contamination after Combat Trauma in Afghanistan, 2009–2011

David R. TribbleComments to Author , Carlos J. Rodriguez, Amy C. Weintrob, Faraz Shaikh, Deepak Aggarwal, M. Leigh Carson, Clinton K. Murray, Penny Masuoka, on behalf of the Infectious Disease Clinical Research Program Trauma Infectious Disease Outcomes Study Group
Author affiliations: Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA (D.R. Tribble, A.C. Weintrob, F. Shaikh, D. Aggarwal, M.L. Carson, P. Masuoka); Walter Reed National Military Medical Center, Bethesda (C.J. Rodriguez, A.C. Weintrob); Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda (A.C. Weintrob, F. Shaikh, D. Aggarwal, M.L. Carson, P. Masuoka); San Antonio Military Medical Center, Joint Base San Antonio, Fort Sam Houston, Texas, USA (C.K. Murray)

Main Article

Figure 1

Geographic distribution of 71 case-patients with invasive fungal wound infections and 101 matched control-patients. Afghanistan, 2009–2011. Inset shows a detailed view of southern Afghanistan region where most cases originated. The IFI case-patients are classified according to established definitions (13). A proven IFI is confirmed by angioinvasive fungal elements on histopathologic examination. A probable IFI had fungal elements identified on histopathologic examination without angioinvasion. A

Figure 1. Geographic distribution of 71 case-patients with invasive fungal wound infections and 101 matched control-patients. Afghanistan, 2009–2011. Inset shows a detailed view of southern Afghanistan region where most cases originated. The IFI case-patients are classified according to established definitions (13). A proven IFI is confirmed by angioinvasive fungal elements on histopathologic examination. A probable IFI had fungal elements identified on histopathologic examination without angioinvasion. A possible IFI had wound tissue grow mold; however, histopathologic features were either negative for fungal elements or a specimen was not sent for evaluation. In addition, to be identified as an IFI, the wound must demonstrate recurrent necrosis after at least 2 surgical débridements. Because injuries frequently occurred in close proximity, some points overlay other points.

Main Article

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1A portion of this material was presented at the Military Health System Research Symposium, August 18–21, 2014, Fort Lauderdale, Florida, USA.

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Page updated: September 22, 2015
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