Infectious complications are responsible for the majority of mortalities and morbidities of patients with critical burns. Although bacteria are the predominant etiological agents in such patients, yeasts and fungi have become relatively common causes of infections over the last decade. Here, we report a case of a young man with critical burns on 88% TBSA (total body surface area) arising as a part of polytrauma. The patient's history of orthotopic liver transplantation associated with the patient's need to use combined immunosuppressant therapy was an additional complication. Due to deep burns in the forearm region, we have (after a suitable wound bed preparation) applied a new bi-layered dermal substitute. The patient, however, developed a combined fungal infection in the region of this dermal substitute caused by Trichoderma longibrachiatum and Aspergillus fischeri (the first case ever reported). The infection caused the loss of the split-thickness skin grafts (STSGs); we had to perform repeated hydrosurgical and mechanical debridement and a systemic antifungal treatment prior to re-application of the STSGs. The subsequent skin transplant was successful.

CEITEC Central European Institute of Technology Brno University of Technology 612 00 Brno Czech Republic

Centre of Molecular Biology and Gene Therapy Department of Internal Medicine Hematology and Oncology Institution Shared with University Hospital Brno Faculty of Medicine Masaryk University 625 00 Brno Czech Republic

Department of Burns and Plastic Surgery Institution Shared with University Hospital Brno Faculty of Medicine Masaryk University 625 00 Brno Czech Republic

Department of Clinical Microbiology University Hospital Brno 625 00 Brno Czech Republic

Department of Clinical Microbiology Vyškov Hospital 628 01 Vyškov Czech Republic

Department of Pathology Institution Shared with University Hospital Brno Faculty of Medicine Masaryk University 625 00 Brno Czech Republic

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