Fournier's gangrene in Mansoura Egypt: A review of 74 cases
Background: Fournier′s gangrene (FG), caused by synergistic aerobic and anaerobic organisms, is a life-threatening disorder in which infection of the perineum and scrotum (can affect penis alone) spreads along fascial planes, leading to soft-tissue necrosis. Despite antibiotics and aggressive debrid...
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Veröffentlicht in: | Journal of postgraduate medicine 2008-04, Vol.54 (2), p.106 |
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Zusammenfassung: | Background: Fournier′s gangrene (FG), caused by synergistic
aerobic and anaerobic organisms, is a life-threatening disorder in
which infection of the perineum and scrotum (can affect penis alone)
spreads along fascial planes, leading to soft-tissue necrosis. Despite
antibiotics and aggressive debridement, the mortality rate of FG
remains high. Materials and Methods: We analyzed 74 patients admitted
to our institution′s emergency surgical unit presenting with FG
between January 2002 and January 2007, considering the anatomical site
of infective gangrene, predisposing factors, etiological agents, and
outcomes. Results: All the 74 patients included in this study were
males; their mean age was 51±10.8 years (21-72 years). The mean
duration from the onset of symptoms to admission to the hospital was
3.74±2.09 days (1-8 days). The mean hospitalization time was
9.2± 6.6 days (1-31). Forty patients (54.05%) had FG secondary to
anorectal conditions. No etiologic factors for FG were found in 27
patients (36.5%). Diabetes mellitus as a predisposing factor was found
in 38 patients (51.35%). There was no definite predisposing factor in
24 patients (32.43%). The microbiological finding was polymicrobial in
48 patients (64.8%) and monomicrobial in 26 patients (35.1%). The most
frequent bacterial organisms were Escherichia coli (75.6%). Simple
sigmoid loop colostomy was done in one patient (1.4%). Unilateral
orchidectomy was done in one case (1.4%). The overall mortality rate
was 16 patients (21.6%). Conclusion: FG is a rapidly progressive,
fulminant infection. Even with aggressive surgical and medical
treatment, mortality of the disease is high. In the present cases, such
a high ratio of 21.6% means that this disease is still serious and
fatal in Egypt. |
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ISSN: | 0022-3859 0972-2823 |
DOI: | 10.4103/0022-3859.40776 |