Although the authors acknowledged that significant diagnostic challenges persist and that weaknesses still exist in their guidelines, progress has been made.
"We’re saving these guys now because the guideline that we developed is allowing us to do a better job," Dr. Malone said. "They’re losing less tissue with surgical debridements, and they’re surviving. So we’ve come a long way since we identified the problem."
Dr. Grace Rozycki
"This observation is important not only for military patients but also for patients with contaminated civilian wounds," said Dr. Grace Rozycki, who was asked to comment on the findings. "As the authors point out, the diagnosis is difficult to make and cultures, although helpful, may take several weeks. A presumptive diagnosis is helpful so that antifungal and antibiotic therapy can be started early," said Dr. Rozycki, chief of the division of trauma/surgical critical care, department of surgery, Emory University, Atlanta.
The project was funded by the National Institute of Allergy and Infectious Diseases and the Department of the Navy under the Wounded, Ill, and Injured program.