Origins of Immunological Impairments in Burns

One of the best examples of the immunodepressed host is afforded by burn patients since the natural protection barriers are broken and the host defenses are no longer operative. In this respect a frequent complication of serious burn injury is sepsis that leads to death in a large percentage of patients surviving the shock phase of such injury (1). In the 1940s, Gram-positive cocci were the main source of the infections but with the discovery of antimicrobial therapy longer the case. Infections are now caused mainly by gram-negative bacilli such as pseudomonas (2) and methicillin-resistant Staphylococcus aureus, Aspergillus Mucor, Herpes virus and Candida (3–5). Pneumonia is also extremely frequent in patients with inhalation injury or shock lung (6). Burn patients may furthermore present suppurative chondritis and thrombophlebitis, pyelonephritis and endocarditis (2,7).