Fournier’s gangrene and intravenous drug abuse: an unusual case report and review of the literature

Zingaro, Michele Del; Boni, Andrea; Vermandois, J.A. Rossi De; Paladini, Alessio; Lepri, E.; Ursi, Pietro; Cirocchi, Roberto; Turco, Morena; Gaudio, Gianluca; Nogara, Andrea; Mearini, Ettore

doi:10.1515/med-2019-0114

Cited by 14 publications

(15 citation statements)

References 170 publications

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“…It has capability in controlling bacteria due to its low pH. Hyperbaric oxygen therapy shortens hospital stay, increaseswound healing and decreases the gangreneous spread (18,30) . Pivodine iodine is used as a primary agent for the wound dressing 21 .…”

Section: Discussionmentioning

confidence: 99%

“…This disease is infective in origin 11 . The Aetiology includes abnormal sexual practices, parentral drug abuse, trauma, insect bite, prior surgical procedures in the perenial region, burns (11)(12)(13)(14)(15)(16)(17)(18) . Predisposing factors of FG's include Diabetes Mellitus , alcoholism, immunosuppression, tobacco abuse, chemotherapy, radiography, atrial Hypertension 28,29,30 .…”

Section: Introductionmentioning

confidence: 99%

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Case Report on Fournier's Gangrene

Gowtham.V

Vaishnavi

Narendra

2020

WJCMPR

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Fournier's Gangrene is a rare condition marked by fluminent polymicrobial necrotising fascitis which involves scrotum and penis, or both with occasional extensions upto the an abdominal wall. Pre disposing factors includes Diabetes mellitus,Immuno compromised patients, Alcoholism, Tobacco, Chemotherapy, Radiography etc. Fournier's Gangrene occurs at any age and it effects mostly in men but also effects women too. We present a case of Fournier's Gangrene -A 40 years old male patient was admitted in emergency department with the complaints of pain over the Testicular region, Itching, Ulcerative over the scrotal region with foul smell & pus discharge and fever. This symptoms have started five day prior to the presentation but symptoms are rapidly progressive in nature since 24 hours of admission. His past medical history reveals that he has Diabetes mellitus type-1 and on medication. He had undergone surgery of hydrocelectomy one month back.The management steps Includes Resustation , Broad spectrum Antibiotics, Surgical debredment and skin grafting. As the patient is known diabetes the chances of infection is more. So early presentation, diagnosis and treatment plays a major role in preventing further complications. In order to do this, we have to provide awareness about the disease among the people.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Case Report on Fournier's Gangrene

Gowtham.V

Vaishnavi

Narendra

2020

WJCMPR

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“…Fournier's gangrene is a life-threatening condition, constituting a urological surgical emergency and has a high mortality rate, ranging from 0 to 67% [ 4 ]. Risk factors for the disease are intravenous drug abuse [ 5 ], radiotherapy [ 6 ], diabetes [ 7 ], cancer, and iatrogenic factors [ 8 – 10 ]. Triggers relating to the exclusive penile zone have been identified as the self-injection of Vaseline in the penis' shaft [ 11 ], self-introduction of beads in the urethra [ 12 ], Phimosis complication [ 13 ], penile abrasion from oral sex [ 3 ], infection by atypical Candida species [ 14 ], and Calciphylaxis [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

A Retrospective Case Series in Fournier’s Disease: And Its Emergency Management et Grafting Technique for Penis Coverage

Tripodi

Guastafierro²,

Gagliardi

et al. 2022

Emergency Medicine International

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Fournier’s gangrene is a necrotizing soft tissue infection of the genital, perineal, and perirectal areas. A primary isolated involvement of the penis is rare, but it can be affected in some circumstances. The purpose of this case series is to present the findings of our thirteen years’ experience in the reconstruction of the penis in Fournier’s gangrene and our full-thickness grafting technique to cover the penis rod. We retrospectively reviewed patient data who underwent a penis reconstruction following Fournier’s gangrene in 2018. The data was analyzed to report the estimated percentage of complications, of patients with primary or secondary gangrene of the penis, the number of reinterventions, and finally the percentage of deaths or recovery. 23 patients underwent reconstruction with our technique of full-thickness skin graft. In all cases, the skin graft was harvested from the upper arm with an arrow shape mark. No further penile revision surgery was required, and neither patient complained about retraction, nor traction, or pain during erection. The donor site healed without any complications. We believe that the coverage of the penis using our grafting technique is safe, easily reproducible, and demonstrates excellent esthetic and functional results.

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“…This condition represents a surgical emergency and has a high mortality rate, ranging from 0 to 67% [ 2 ]. Several authors worked hard to determine the cause generating this inflammatory infectious process [ 3 , 4 ], and several triggers were identified as intravenous drug abuse [ 5 ], radiotherapy [ 6 ], diabetes [ 7 ], obesity [ 8 ], anal and urogenital disease [ 9 ], cancer, and iatrogenic factors [ 10 , 11 ]. It has been hypothesized that Fournier’s gangrene may be determined by a polymicrobial infection progressing to obliterative endarteritis with microthrombosis of the cutaneous and subcutaneous arterioles and consequent peripheral spread of bacteria, causing gangrene of the overlying tissues [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

Algorithm of rational approach to reconstruction in Fournier’s disease

et al. 2021

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Background Fournier’s gangrene is a rare form of necrotizing fasciitis that affects the genital area up to the perineal region and sometimes the abdominal wall. Objectives Our article aims to show that in the treatment of extensive forms of Fournier’s gangrene, correct use of flap and skin grafts and a quick reconstruction of the exposed tissues avoid scarring retraction of the testicles and deformation of the penis. Materials and methods We retrospectively reviewed the clinical and photographic data of Fournier’s gangrene cases treated at our Institute. The data were evaluated to obtain an estimate of the results of the reconstructive technique used, in terms of percentage of occurred healings and eventual complications. Results A total of 34 patients underwent surgery for Fournier’s gangrene. In nine cases (26.5%), we had minor complications: in four patients, suffering from diabetes and obesity, a retard in attachment of graft occurred, while in five patients with perianal problems there was a delay in healing due to the onset of local infection. Conclusion The reconstruction approach described here may reduce surgical times. In Fournier’s gangrene, the exposed tissues must be reconstructed as quickly as possible.

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Fournier’s gangrene and intravenous drug abuse: an unusual case report and review of the literature

Cited by 14 publications

References 170 publications

Case Report on Fournier's Gangrene

Case Report on Fournier's Gangrene

A Retrospective Case Series in Fournier’s Disease: And Its Emergency Management et Grafting Technique for Penis Coverage

Algorithm of rational approach to reconstruction in Fournier’s disease

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