Most case series of Fournier's gangrene (FG) do not list malignancy as a cause; however, isolated cases with underlying malignancy of the soft tissue, genitourinary, and gastrointestinal systems have been described. After a review of recently published literature, 20 case reports and 15 case series or review articles included relevant information and were included in this literature review. Malignancy is overlooked in 10% (2/20) of patients, resulting in a delayed diagnosis and initiation of cancer treatment. All patients with FG should have a thorough cancer history, digital rectal examination, appropriate local and systemic imaging, as well as tissue biopsies, to reduce the likelihood of a missed cancer diagnosis. Delay in management of the local malignancy may lead to persistence or recurrence of the infection and significantly worsens overall outcome and survival.
Guillain Barré Syndrome (GBS) is an antibody mediated peripheral nerve disorder that commonly presents after infection, usually campylobacter jejuni.8 Guillain Barré can be broken down into two different forms: axonal and demyelinating. The demyelinating form is termed acute inflammatory demyelinating polyneuropathy. The axonal form can further be categorized into acute motor neuropathy and acute motor and sensory neuropathy. In typical cases of GBS, patients present with acute, progressive, symmetrical, ascending flaccid paralysis reaching peak severity within 5-9 days of symptom onset. All forms of GBS are diagnosed clinically. Patients who present with the progression of symptoms as mentioned above are thought to have GBS unless a better diagnosis is available.7 However, diagnosing GBS can become difficult when patients present with atypical symptoms. The case discussed in this article focuses on the complexity of diagnosing and treating patients who present with atypical GBS symptoms.
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