Extended Retroperitoneal Necrotizing Fasciitis with Genital Involvement, Resembling Fournier Gangrene

Sugimoto, Motokazu; Matsuura, Kenji; Takayama, Hiromitsu; Kayo, Munefumi; Ie, Tomotsugu

doi:10.1089/sur.2008.101

Cited by 13 publications

(22 citation statements)

References 16 publications

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“…Extra-abdominal primary sources of infection with retroperitoneal spread have also been described, most commonly involving necrotizing fasciitis of the extremities. However, not all cases have a definitive source of infection (23)(24)(25)(26). The majority of reported cases of retroperitoneal fasciitis are due to polymicrobial infections (5,15,25,27,28).…”

Section: Teaching Pointsmentioning

confidence: 99%

“…Single-organism Streptococcus (b-hemolytic group A or other) infections were more commonly isolated in cases of retroperitoneal fasciitis that are due to retroperitoneal extension from necrotizing fasciitis of the lower extremities (26,29). Not surprisingly, the most common causative agent of necrotizing fasciitis in the extremities is bhemolytic group A Streptococcus (2,7), followed by methicillin-resistant S aureus (30).…”

Section: Teaching Pointsmentioning

confidence: 99%

“…Necrotizing retroperitoneal fasciitis is associated with a higher mortality and has been considered an almost uniformly lethal infection with survival reported in only a few cases (5,25,26,48). In contrast, Mokoena et al (1) reported a remarkable 20% mortality in a group of 10 patients.…”

Section: Treatment and Outcomementioning

confidence: 99%

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Retroperitoneal Fasciitis: Spectrum of CT Findings in the Abdomen and Pelvis

et al. 2015

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Retroperitoneal fasciitis is a rare but potentially lethal complication of infection. Early diagnosis is crucial and is usually made when there is a high degree of clinical suspicion combined with characteristic imaging findings leading to early surgical intervention. Computed tomography (CT) can play a central role in demonstrating early findings, assessing the extent of disease to help determine the best surgical approach, identifying the primary source of infection, and evaluating the treatment response. The possible presence of retroperitoneal fasciitis should be considered in patients presenting with symptoms of sepsis, including pain that is disproportionate with the clinical abnormality. When retroperitoneal fasciitis is suspected, emergency CT can facilitate early diagnosis and evaluation of the extent of disease. Common findings at CT include fascial thickening and enhancement, muscular edema, fat stranding, fluid collections, and abscess formation. Gas tracking along fascial planes in the retroperitoneum is the hallmark of retroperitoneal fasciitis but is not seen in all cases. Another important clue to the diagnosis is asymmetric involvement of the retroperitoneal fascial planes and deep tissues. Fasciitis in the retroperitoneum may originate from infected retroperitoneal organs or from infection that spreads along indirect and/or direct pathways from a primary source elsewhere in the body. Findings of indirect tracking and transgression of fascial planes may indicate more severe infection associated with the necrotizing form of retroperitoneal fasciitis. Despite aggressive antibiotic treatment, early and repeated surgical débridement may be required to remove nonviable tissue in patients with the necrotizing form of retroperitoneal fasciitis. Awareness of the anatomy of the retroperitoneum, potential routes of spread of infection, and the spectrum of CT findings in retroperitoneal fasciitis is needed to achieve prompt diagnosis and guide treatment.

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Section: Teaching Pointsmentioning

confidence: 99%

Section: Teaching Pointsmentioning

confidence: 99%

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Retroperitoneal Fasciitis: Spectrum of CT Findings in the Abdomen and Pelvis

et al. 2015

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“…Review of the English literature over the last 20 years shows 20 reports of NF as manifestation of rectal cancer 1–20. In 13 reports it presents as Fournier gangrene which is NF of the perirectal, perineal or genital area 1 2 4–10 13 14 17 20 21. In one case the rectal cancer presented with NF of the abdominal wall 11.…”

Section: Discussionmentioning

confidence: 99%

“…The reported death rate of NF varies between 3% and 80% 7 20. Mortality is related to the degree of sepsis and the general condition of the patient at the time of diagnosis 22.…”

Section: Discussionmentioning

confidence: 99%

Necrotising fasciitis of the thigh

Haemers

Peters²,

Braak

et al. 2013

BMJ Case Reports

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Necrotising fasciitis (NF) is an extremely virulent form of infectious fasciitis. It affects skin, subcutaneous fat and superficial and deep muscular fascia by rapidly progressive necrosis. Expeditious diagnosis and radical debridement is necessary to prevent the onset of sepsis, multisystem organ failure and possible death. Perforated rectal cancer resulting in NF can spread to the perineum and genitals known as Fournier gangrene. This case describes an unusual case of NF of the right thigh as first presentation highly suggestive for rectal cancer.

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