Candidiasis in the Burned Patient

Candida organisms were cultured from 452 of 1,513 hospitalized burned patients during a 6-year study period. Of the 172 patients with colonization of the eschar by this fungus, only 20.7% subsequently developed invasive candidal sepsis. The mortality of untreated Candida burn wound infection was 100%, and with aggressive medical-surgical therapy, 91.6%. Candidemia was present in 52 patients and 76.9% of these died. Candida infection was seen as a preterminal phenomenon, coincident with a generalized collapse of patients' defensive and homeostatic mechanisms. For this reason, mortality was high and the infection rarely responded to treatment. Control of this lethal complication rests with prevention by the judicious use of intravenous broad-spectrum antibiotics and expeditious closure of the burn wound.