Table 2.
Definitions for the classification of fungal evidence collected from combat trauma-related wounds (reprinted from Ganesan et al. 2019) [16]
| Term | Definition |
|---|---|
| Persistent necrosisa | Presence of necrosis after two or more surgical debridements |
| Persistent laboratory evidence of fungal infectiona | Presence of positive histopathology and/or culture after two or more surgical debridements |
| Wounds meeting criteria for Invasive Fungal Infections (IFI) | Includes wounds with persistent necrosis and persistent laboratory evidence of fungal infection |
| Wounds Highly Suspicious for Fungal Infection (High Suspicion wounds) | Includes wounds, that did not meet the criteria for an IFI, but had signs and symptoms suggestive of a deep skin and soft tissue infection (dSSTI)b ascribed to a fungus (based on the use of antifungals for ≥10 days and a physician report). Wounds that did not meet criteria for an IFI, but needed a proximal amputation were included irrespective of the duration of antifungal use. |
| Wounds with Low Suspicion for Fungal Infection (Low Suspicion wounds) | Includes wounds that did not meet the criteria for an IFI and did not meet the criteria for a dSSTI. This category also includes wounds with signs and symptoms of a dSSTI attributed to bacteria (based on physician report or the use of antifungals for <10 days) but with laboratory evidence of fungus (i.e. positive fungal cultures and or histopathology) |
a
This excludes any additional debridement that was performed in the battlefield hospitals in Afghanistan
b
The Centers for Disease Control and Prevention National Healthcare Safety Network criteria for deep skin and soft-tissue infections were adapted for this definition [21].