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Abstract

Fournier's gangrene is a life-threatening disorder in which infection of the perineum and scrotum spreads along fascial planes, causing soft tissue necrosis. If urgent surgery is delayed, the disease will soon result in septic shock, multiorgan failure, and death. In this study, we present 21 patients with Fournier's gangrene who were treated in period between 1994 and 2001. Patients' charts were reviewed retrospectively and are discussed in the light of literature. All patients received aggressive surgical debridment. Penicillin or Ceftriaxone, aminoglicoside and metronidazole were administered intravenously. Of the 21 patients, 5 had scrotal carbuncle, 1 had urethral stricture, 1 had chronic indwelling urethral catheterization, 2 had perirectal abscess, and 1 had hemorrhoidectomy. In eleven patients we couldn't identify any cause. Twelve patients had diabetes mellitus, and two had chronic alcoholism. Escherichia coli was isolated in 12 purulent tissue cultures, and Bacteroides fragilis in eight. Seventeen patients survived, whereas four died. Fourier's gangrene is considered a surgical emergency. Early surgical intervention is essential, as the gangrene can spread rapidly at rates reaching 2 mm per hour. So that Fournier's gangrene is an abrupt, rapidly progressive, gangrenous infection of the external genitalia and perineum and is a real urologic emergency.

Is hemoglobin A1c level effective in predicting the prognosis of Fournier gangrene?

“…Most frequently isolated microorganisms include E. coli (80%), Klebsiella pneumonia , Bacteroides , Pseudomonas , Staphylococci , and Enterobacter species. [ 10 19 22 ] In the present study, the most frequently isolated microorganism was E. coli , and other isolated microorganisms were similar to the previous studies.…”

Fournier’s Gangrene after Open Hemorrhoidectomy without a Predisposing Factor: Report of a Case and Review of the Literature

“…Only eight cases of FG have previously been reported after hemorrhoidectomy [5, 15, 16, 17, 18, 19, 20, 21]. This case is the second description of unforeseeable and unpredictable FG development after open hemorrhoidectomy in a patient otherwise healthy without a predisposing factor.…”

“…The patients should receive antibiotic therapy, including regimens against aerobic and anaerobic microorganisms [1,7]. This treatment goal can be achieved by means of a penicillin-based drug in combination with metronidazole [18]. …”

Complicated Urethral Rupture and Scrotal Urethrostomy in a Bongo Antelope (Tragelaphus eurycerus isaaci)

“…2,5 If surgery is delayed, the disease will quickly lead to septic shock, multiorgan failure, and death. 1 Good management is based on aggressive surgical debridement, broad-spectrum antibiotics, and intensive supportive care, resulting in decreased mortality. 7 In ruminants, some authors suggest that multiple stab incisions can be made into the subcutaneous tissue to allow for the escape of urine.…”