Case report: treatment of Fournier's gangrene of the shoulder girdle

Abstract

Fournier's gangrene is a rare, high-mortality infection that affects the subcutaneous tissue with rapidly progressive necrosis. The objective is to report a case of Fournier's gangrene involving the region of the shoulder girdle after closed fracture of the clavicle, and to discuss this unusual evolution. The patient underwent a series of surgical procedures and was followed up on an outpatient basis for 12 months, at which point she was discharged. Fournier's gangrene is an aggressive lesion and requires early diagnosis (clinical-laboratory correlation) with the appropriate adequate surgical approach and clinical stabilization.

Case Report on Fournier's Gangrene

“…Fournier's Gangrene is a rare 11 condition marked by fluminent polymicrobial necrotising fasciitis [1][2][3][4][5][6][7][8][9][10] , which is generally localised disease of scrotum or penis or both with occasional extention up to the abdominal wall 11 . In literature many terms have been used synonymously to describe the condition which include idiopathic gangrene of the scrotum, periurethralphelgmon, streptococcal scrotal gangrene and cenegesiticnecrotising cellulitis.…”

“…If the patient is not managed Page192 aggressively at this stage, the condition of the patient may worsen and sepsis with multiple organ failure may follow 22 . It may occurs in both females and males [2][3][4] . The present ratio of incidents is 1:10 12 .…”

“…The synergistic microbial activity results in production of various exotoxins and enzymes like collagenase, heparinase, hyaluronidase, streptokinase and streptodornase, which lead to tissue destruction and spread of infection. The aetiological factors of Fournier gangrene are obesity 9 , diabetes mellitus, abnormal sexual practices, alcohol abuse [9][10][11][12][13][14][15] , infection of gastrointestinal tract 3 , tissue ischemia [3][4][5][6][7][8][9][10][11][12] . When it comes to children the main aetiological factor is diaper rash 17 , pelvic injury, omphalitis, localised abscess, circumcision [24][25][26][27] .…”