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At least 19 recordsLinked to original sources
PubMed2005

Group C streptococcal sepsis complicating Fournier gangrene.

Fournier gangrene is a life-threatening necrotizing fasciitis of the perineal-scrotal area that occurs in diabetic males. Patients typically present with systemic toxicity and significant inflammatory changes in the scrotum and perineum. Most cases of Fournier gangrene are polymicrobic and require urgent surgical debridement and broad-spectrum antibiotic therapy. We describe a case of Fournier gangrene in a young diabetic man that was associated with group C streptococcal bacteremia, an association previously unreported in the literature to our knowledge.

Adult↗
PubMed2006

Fournier gangrene.

Fournier gangrene is a necrotizing infection involving the soft tissues of the male genitalia. It was first described in 1764 by Baurienne and given its eponymous name after Jean-Alfred Fournier in 1883 presented a case of perineal gangrene in an otherwise healthy young man. While only 600 cases of Fournier gangrene have been reported in the world literature since 1996, it is a common and serious disease in Africa. In Maputo Central Hospital alone, between 12 and 16 cases are admitted every year and treated with a 20% mortality. The typical patient is an elderly male in his sixth or seventh decade with co-morbid diseases. While considered to affect males only, a similar condition may occasionally affect the female genitalia.

Female↗
PubMed1995

[Fournier gangrene].

Fournier's gangrene is a relatively rare, mixed aerobic and anaerobic soft tissue infection in the perineoscrotal area. Although it is convenient to give it a separate name, it is really either necrotizing fasciitis or nonclostridial myonecrosis of the scrotal and perineal areas. The condition frequently develops from perineal diseases, including perianal abscess, and fistulas, inflamed haemorrhoids and indwelling urethral catheter. In patients with Fournier's gangrene morbidity is extreme and mortality high. This article is based on a retrospective study of 15 cases of Fournier's gangrene, 13 in male and 2 in female patients. A combination of surgery and antibiotics was used to treat 9 patients. The last 6 cases were treated with a combination of surgery, antibiotics and hyperbaric oxygen. In 13 cases, the diagnosis was made on the basis of the fulminating progression of the infection to a scrotal gangrene, identification of multiple underlying pathogenic organisms and toxaemia. In the 2 female patients, a similar infection developed in the labia majora and perineum and extended to the buttocks and the anterior abdominal wall.

Adult↗
PubMed1982

Polymicrobial genital gangrene (Fournier's gangrene): clinical, microbiologic, and therapeutic features.

The microbiologic and therapeutic aspects of polymicrobial genital gangrene (Fournier's gangrene) studied in nine patients are presented. Seven patients had both aerobic and anaerobic bacteria isolated from the site of infection; four had Bacteroides and two, Clostridia. Broad-spectrum penicillins such as ticarcillin, mezlocillin, and piperacillin, or combined clindamycin and gentamicin therapy were used. One patient died of fulminating infection and eight patients were cured of their infections. Anaerobic bacteria and appropriate antibiotic therapy should be considered in all patients with genital gangrene.

Adult↗
PubMed1997

[Fournier gangrene].

Fournier's gangrene is a rapidly spreading soft tissue infection. Applying our main principles of therapy to the four patients we have treated in the past 4 years, all patients survived. One case report is presented in detail. Early diagnosis is essential. CT plays an important role. Aggressive resuscitation, daily surgical exploration and debridement remain the key to the management of this disease. The prevention of orchidectomy is one of our aims. Faecal diversion is seldom necessary.

Adult↗
PubMedDate not supplied

[Perineo-scrotal gangrene (Fournier's gangrene)].

Four cases of perineoscrotal gangrene are reported herein. All were immune-suppressed and three were diabetics. Its primary focus was in the GU tract or intestine. Culture was positive for Gram-negative aerobes and anaerobes. Early aggressive surgery and adjuvant antibiotic therapy achieved an excellent survival rate.

Aged↗
PubMed2005

Prognostic factors in Fournier gangrene.

AIMS: Fournier gangrene is a rapidly progressive necrotizing fasciitis involving the genitalia. It can be treated with antibiotics and immediate debridement along with treatment of the predisposing condition. We evaluated the prognostic factors, clinical characteristics and treatment of patients of the Fournier gangrene. METHODS: The subjects were 40 male patients diagnosed with Fournier gangrene who visited Wonkwang University Hospital, Iksan, Korea between January 1991 and December 2000. Their medical records were reviewed with respect to demographics, medical history, symptoms and signs, physical examination, laboratory data, bacteriology, extent of disease, clinical course, and therapy. The extent of disease was quantified for each patient using a modification of the diagram used to assess the extent of burns. RESULTS: The average age was 55.3 years (range 29.6-92.8). Of the 40 patients, 11 died (36%) and 29 survived (64%). Anorectal infections were the underlying local disease most commonly associated with high mortality (75%). Although the most common associated illness was diabetes, it was not related to the prognosis (death rate: 20.0%). In contrast, the death rate was highest in chronic renal failure, reaching 50%. The mortality rate increased with the duration of symptoms before hospitalization. Patients with <6% surface area involvement were more likely to survive. On admission, serum blood urea nitrogen (s-BUN) and serum creatinine were significantly higher in the patients who died. CONCLUSION: Survival is associated significantly with anorectal infection, chronic renal failure, the duration of symptoms before hospitalization, the extent of gangrene, and s-BUN and creatinine level on admission.

Adult↗
PubMed2003

[A chicken bone as cause of Fournier gangrene].

OBJECTIVES: Fournier's gangrene is a synergistic infective necrotizing fascitis, which involves perianal, perineal and genital regions, with rapid evolution and severe prognosis. We perform a literature review and report a recent case. METHODS: We report the case of a male patient who presented with scrotal pain and history of excretion of a chicken bone in a bowel movement. RESULTS: Despite aggressive surgery and wide spectrum antibiotic, the prognosis severe and the mortality is high. CONCLUSIONS: Rapid and accurate diagnosis remains the key to achieving a successful outcome. Early, wide and repeated debridement procedures reduce the mortality.

Foreign-Body Migration↗
PubMed2005

Fournier gangrene in spinal cord injury: a case report.

BACKGROUND: Fournier gangrene is a necrotizing fasciitis of the perineal and genital region resulting from polymicrobial infection in which infection spreads along fascial planes, causing soft-tissue necrosis. If surgical debridement and control of infection are delayed, the disease can progress and result in septic shock, multiorgan failure, and death. Initial symptoms are severe pain in the genital region followed by swelling and erythema. In patients with spinal cord injury (SCI), lack of pain sensation could cause delay in seeking medical attention. SCI patients are at higher risk for Fournier gangrene secondary to neurogenic bladder, neurogenic bowel, and impaired sensation. A literature search resulted in only 1 report of Fournier gangrene with localized necrosis of the scrotum in a patient with SCI. METHODS: Case report of a 47-year-old man with C4 tetraplegia. RESULTS: Patient presented with a necrotic ulceration on the ventral aspect of the penis and scrotum of 2 days duration and was diagnosed with fulminant Fournier gangrene. CONCLUSIONS: Patients with SCI are at higher risk for Fournier gangrene secondary to neurogenic bladder, neurogenic bowel, and impaired sensation. Mortality is high. Prevention and early diagnosis are essential. Prompt aggressive intervention is warranted to maximize outcomes.

Cervical Vertebrae↗
PubMed2006

[Extensive Fournier gangrene. A dermatologic emergency].

Fournier gangrene is a necrotizing fasciitis of the perineal and genital region, which almost exclusively affects men. The cause is a polymicrobial infection associated with superficial trauma, urological diseases and operations, as well as colorectal diseases. Diabetes mellitus, alcoholism, immunosuppression and other severe illnesses are frequent co-factors. Immediate administration of systemic broad-spectrum antibiotic therapy with coverage of both gram-positive and gram-negative bacteria combined with surgical debridement and intensive medical care can lower the high mortality rate of this condition.

Adult↗
PubMed1983

Idiopathic gangrene (Fournier) of the male external genitalia, with report of a case and review of the literature.

Fournier's gangrene, originally described by Fournier in 1883, is a rare and unusual ischaemic necrosis of the male external genitalia. Reports on the idiopathic penile and/or scrotal gangrene are relatively rare in newer publications. The aetiology of the disease which is characterized by a sudden onset, most commonly without prodromal symptoms, is still not fully understood. There is strong evidence, however, that Fournier's gangrene is a specific infection due to Streptococcus haemolyticus, group A, and/or anaerobic Streptococci. Presenting a case of our own, we take the opportunity to discuss the pathogenesis, pathomorphology, bacteriology and treatment of the disease.

Adult↗
PubMed1998

[Fournier gangrene: our experience].

OBJECTIVE: Fournier's gangrene is a necrotizing fasciitis involving the genitoperineal region caused by the synergistic action of aerobic and anaerobic pathogens. It is a rapidly progressing disease and carries a high mortality. Our experience with Fournier's gangrene is presented. METHODS: Herein we describe 11 cases of Fournier's gangrene that were diagnosed and treated from 1991 to 1996. The most important predisposing factor was diabetes mellitus and the most common triggering factor was a perianal condition. RESULTS/CONCLUSIONS: The survival rate was high (81%) and can be ascribed to early diagnosis, aggressive and rapid surgical treatment with debridement, resection of the necrotic areas, drainage, simultaneous broad spectrum antibiotic therapy and frequent local treatment.

Aged↗
PubMed1992

Gangrene and Fournier's gangrene.

Fournier's gangrene is an aggressive disease affecting the perineum. Clearly, it can no longer by considered idiopathic in its origin, as most infection can be localized to a cutaneous, urethral, or rectal source. It presents in a broad age range and can have an indolent onset, thus requiring a high index of suspicion. It may be fulminant and progressive in the case of immunocompromise and underlying debilitating illnesses. Despite aggressive antibiotic therapy and debridement, it is associated with a high mortality rate. This rate has been higher in older patients, those with a rectal focus, and diabetics. Hyperbaric oxygen therapy has shown some promise in shortening hospital stays, increasing wound healing, and decreasing the gangrenous spread when used in conjunction with surgical debridement and antibiotics. New reconstructive efforts, such as medial thigh myocutaneous flaps, have improved the cosmetic aftermath of the extensive debridement. Fournier's gangrene remains a true urologic emergency, which mandates aggressive initial care by means of early recognition, early hemodynamic stabilization, and the institution of parenteral broad-spectrum antibiotics. This is followed by multiple debridements and in some cases urinary or rectal diversion. The concomitant use of hyperbaric oxygen therapy in selected cases followed by meticulous reconstructive surgery and salvage has further reduced the mortality rate and improved the cosmetic outcome.

Gangrene↗
PubMed2000

Fournier gangrene associated with Crohn disease.

A 17-year-old boy presented with Fournier gangrene associated with previously undiagnosed Crohn ileocolitis. Fournier gangrene was managed by débridement, broad-spectrum antibiotics, and hyperbaric oxygen. A diverting ileostomy was performed before skin grafting and scrotal reconstruction. Microscopy of a full-layer surgical sample from the terminal ileum revealed granulomas with multinucleated histiocytes, consistent with Crohn disease. Crohn disease was treated with mesalamine, metronidazole, 6-mercaptopurine, and infliximab. The patient was discharged on hospital day 32. At 6-month follow-up, reconstruction of his scrotum had completely healed. Ostomy output was normal.

Adolescent↗
PubMed1983

A case of idiopathic scrotal gangrene (Fournier) with perineal extension.

A case of idiopathic or Fournier's gangrene of the scrotum is described with unusual extension to the perineum. The clinical features of this disease are summarized. The literature is reviewed for extra genital extension of this gangrene of unknown aetiology. Coincidental association between infections with Onchocerca volvulus and scrotal gangrene was observed.

Adult↗
PubMed1989

[Perineoscrotal Fournier gangrene].

Necrotizing perineoscrotal infection, Fournier's gangrene, is a relatively rare condition with recognized predisposing and local precipitating factors. Early diagnosis and aggressive therapy permit reducing its high mortality. Seven cases with this condition are described there were no deaths.

Adult↗
PubMed1987

[Fournier gangrene--also in females?].

Fournier's gangrene with necrotizing infection of perianal region, the left ureter and the lower extremities is described. It is an aerobic and anaerobic necrotizing subcutaneous infection (non gas gangrene) with a specific course.

Abdominal Muscles↗