Status - Live
Protocol - Invasive Fungal Infections (IFI)
Description - Invasive fungal infections (IFbI) are devastating and threaten both life and limb. Typically rare in immunocompetent individuals, IFI have developed with remarkable frequency in severely combat-injured patients, particularly those sustaining multi-system blast trauma with associated abdomino-pelvic injuries, multiple amputations, and/or requiring massive early lifesaving transfusions. Despite the high survival rate of our wounded warriors from the current conflicts, some such patients have succumbed to these aggressive infections after reaching military medical centers. Surviving patients have complex, morbid clinical courses frequently requiring multiple additional procedures and proximal migration of amputations, with high associated complication rates. Using a large database of combat-injured personnel, we have developed Clinical Decision Support Tools to allow early IFI risk stratification at either the in-theater or medical center echelons of care; these tools were subsequently externally validated utilizing a separate, similar database. These tools can facilitate the early diagnosis and aggressive prophylactic local and systemic treatment of patients at high risk for IFI, which we believe is critical to mitigate IFI-associated morbidity and mortality.