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Clinical Signs of Invasive Infection of Burn Wound

Purpose: To evaluate a burn wound for clinical signs suggesting an invasive infection based on the criteria of Cioffi et al.

Description

A burn wound that has developed an invasive infection may show a number of clinical signs. There is a tendency for infections to be caused by organisms resistant to topical antimicrobials or antibiotic prophylaxis, such as Pseudomonas aeruginosa or fungi.


General signs:

(1) discoloration of eschar (dark red, brown, black) not related to desiccation

(2) progression of necrosis (partial thickness injury becomes full thickness)

(3) hemorrhagic discoloration in the soft tissue beneath the escar

(4) edema and/or violaceous discoloration involving unburned skin surrounding the burn wound margin

 

Signs suggestive of Pseudomonas aeruginosa infection:

(1) presence of greenish pigment in the soft tissue surrounding the wound

(2) ecthyma gangrenosum in unburned skin

 

Signs suggestive of fungal infection:

(1) accelerated separation of the eschar from the wound

(2) rapid, centrifugal change with central necrosis and peripheral edema

 

Signs of infection with herpes simplex virus:

(1) vesicular lesions

(2) facial burn wound with brown, crusted, serrated margins


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Specialty

Objective

ICD-10