Measures:
(1) persistent necrosis: necrosis present after 2 or more surgical debridements
(2) persistent laboratory evidence of fungal infection: evidence of fungus (histopathology, culture, molecular) after 2 or more surgical debridements
(3) deep skin and soft tissue wound infection (SSTI): localized signs and symptoms of infection (pain, tenderness, etc) with spontaneous dehiscence and/or need for surgical intervention
Invasive fungal infection (IFI): SSTI with both persistent necrosis and persistent laboratory evidence
High-suspicion - all of the following:
(1) does not meet criteria for IFI
(2) clinical diagnosis deep skin and soft tissue infection (SSTI)
(3) findings implicating infection due to a fungus (use of antifungal therapy >= 10 days, physician diagnosis, proximal amputation)
Low-suspicion - all of the following:
(1) does not meet criteria for IFI or high suspicion
(2) clinical diagnosis deep skin and soft tissue infection (SSTI)
(3) findings implicate bacteria as cause
(4) laboratory evidence of fungus
