&lt;p&gt;Fournier Gangrene in the Emergency Department: Diagnostic Dilemmas, Treatments and Current Perspectives&lt;/p&gt;

Auerbach, Jonathan; Bornstein, Kasha; Ramzy, Mark; Cabrera, Jorge L.; Montrief, Tim; Long, Brit

doi:10.2147/oaem.s238699

Cited by 51 publications

(76 citation statements)

References 96 publications

(172 reference statements)

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“…The ultrasound did not show subcutaneous thickening, air, fascial fluid, “cobblestoning” of the subcutaneous soft tissue, or “snow globe” or “dirty shadowing,” or other signs suggestive of FG. 1 , 5 , 9 Due to the severity of pain in a patient with multiple risk factors for FG, urology was urgently consulted.…”

Section: Discussionmentioning

confidence: 99%

“…Our patient had multiple risk factors for FG including male sex, age greater than 50, diabetes, hypertension, and being overweight (body mass index (BMI): 29.7 kg/m 2 ). 1 , 3 In such patients when there is a high suspicion for FG, one must repeat physical examination frequently.…”

Section: Discussionmentioning

confidence: 99%

“…Auerbach et al report that FG is misdiagnosed in up to 75% of cases which leads to higher morbidity and mortality. 1 FG can begin as a simple abscess or cellulitis and rapidly progress to a necrotizing soft tissue infection involving necrosis of deep contiguous tissues and pelvic organs. With deep infections, there may not be any evidence of the infection on skin examination.…”

Section: Discussionmentioning

confidence: 99%

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Fournier’s gangrene mimicking an acute epididymitis

Larsen

Paige

Mutyala

et al. 2021

SAGE Open Medical Case Reports

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Fournier’s gangrene is a urologic emergency secondary to a necrotizing soft tissue infection. Fournier’s gangrene is characterized by severe pain and features of Fournier’s gangrene may include edema, blisters and bullae, crepitus, subcutaneous gas, and systemic symptoms. Risk factors include male gender, alcohol abuse, immunocompromised state, uncontrolled diabetes mellitus, obesity, and malignancy. The diagnosis is made clinically but is often supported by radiography, ultrasound, computed tomography, and magnetic resonance imaging. Treatment consists of emergent hospitalization and surgery to debride the necrotic tissues. Morbidity and mortality for Fournier’s gangrene are very high if left untreated. Early surgical intervention is key to the successful treatment of Fournier’s gangrene. This case report presents a case of Fournier’s gangrene mimicking acute epididymitis and highlights the importance of a thorough physical examination with high clinical suspicion for Fournier’s gangrene.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Fournier’s gangrene mimicking an acute epididymitis

Larsen

Paige

Mutyala

et al. 2021

SAGE Open Medical Case Reports

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“…Subcutaneous crepitus with a putrid odor (due to anaerobic microbial activity) may appear toward the end of the infection. Eventually, the infection manifests as gangrene, which has more obvious physical signs [ 46 ]. Due to a separate blood supply from the penis and scrotum, the testicles are often spared [ 47 ].…”

Section: Reviewmentioning

confidence: 99%

“…The FGSI can be used in an emergency to determine the likelihood of survival or death by rating nine clinical parameters on a scale of 0 to 4. In patients with FG, a score of greater than or less than 10.5 indicates a 96% chance of death or survival, respectively [ 46 ].…”

Section: Reviewmentioning

confidence: 99%

Fournier’s Gangrene Diagnosis and Treatment: A Systematic Review

Lewis¹,

Majeed²,

Olang³

et al. 2021

Cureus

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Fournier's gangrene (FG) is a perineal and abdominal necrotizing infection. It is most commonly found in middle-aged men with comorbidities such as diabetes mellitus. Initial symptoms are often indistinct and can rapidly progress to overwhelming infections with a relatively high mortality rate. It is crucial to make a prompt diagnosis so that the patient receives appropriate treatment. Given the importance of the identification of FG, we explored what were the most common signs and symptoms associated with FG, as well as distinguished the gold standard treatment. This systematic review utilized articles identified exclusively through PubMed using key terms such as Fournier's gangrene, signs, symptoms, and treatment. A total of 37 studies, including a total of 3,224 patients (3,093 males and 131 females), fit our inclusion parameters for relevance that included either the most identifiable presentation of FG or the most effective treatment. From our search, the most common clinical presentation was scrotal and labial pain, fever, abscesses, crepitus, erythema, and cellulitis. Diagnosis is made from clinical findings in conjunction with imaging. The gold standard for treatment was found to be a combination of surgical debridement, broadspectrum antibiotics, and the administration of intravenous fluids. Further, patient survival was found to be directly related to the time from diagnosis to treatment when they underwent surgical debridement. The importance of early identification for improved outcomes or survival highlights the need for further studies or measures to enhance the identification of the signs and symptoms of FG.

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HIV and the Skin

Bunker,

Piguet

2024

Rook's Textbook of Dermatology

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Within 2 years of defining acquired immune deficiency syndrome (AIDS) as a distinctive syndrome in 1981, human immunodeficiency virus (HIV) was identified as the causative agent. Dermatological involvement in AIDS has been appreciated since the disease was first recognised. Mucocutaneous involvement establishes criteria for diagnosis and staging; the prognostic significance of some complications, for example pruritic papular eruption/eosinophilic folliculitis, hairy leukoplakia and Kaposi sarcoma (KS), was well recognised before specific treatments were introduced. The proportion of patients with skin complications and the number of these manifestations in any one patient increase as HIV infection progresses and AIDS develops. The incidence and severity of several common cutaneous diseases (such as mollusca, herpes simplex and seborrhoeic dermatitis) are increased in patients with HIV and this correlates in many instances with the absolute numbers of CD4+ T cells. The effect HIV infection may have on some dermatological conditions such as psoriasis and leprosy is less clear‐cut. The advent of highly active combined antiretroviral therapy (ART) has been incalculably beneficial to patients with HIV, but novel side effects of these drugs (such as lipodystrophy) have emerged, and the skin can be affected by manifestations of the immune reconstitution inflammatory syndrome/immune reconstitution associated disease. The dermatological complications of HIV and AIDS may be distressing to patients and difficult for dermatologists to diagnose and manage. Also, many dermatoses presenting in the population at large need to be regarded as ‘indicator conditions’ to prompt advice about, and initiation of, HIV testing.

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<p>Fournier Gangrene in the Emergency Department: Diagnostic Dilemmas, Treatments and Current Perspectives</p>

Cited by 51 publications

References 96 publications

Fournier’s gangrene mimicking an acute epididymitis

Fournier’s gangrene mimicking an acute epididymitis

Fournier’s Gangrene Diagnosis and Treatment: A Systematic Review

HIV and the Skin

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