Fournier 's gangrene: Literature review and case report

Aleksandar Jakovljević Orcid logo ,
Aleksandar Jakovljević
Gojko Igrutinović ,
Gojko Igrutinović
Nikola Miljković ,
Nikola Miljković
Mladen Kasalović ,
Mladen Kasalović
Danijela Vićentijević
Danijela Vićentijević

Published: 01.12.2021.

Volume 51, Issue 3 (2022)

pp. 53-56;

https://doi.org/10.5937/pramed2204053j

Abstract

Fournier's gangrene is a progressive necrotizing bacterial dermo-hypodermitis of the perineum and external genitalia. It represents a secondary polymicrobial infection with an aerobic and anaerobic group of bacteria, which have a synergistic effect in the development of this disease. Fournier's gangrene is an urgent, potentially life-threatening, medical condition that requires a multimodal approach: surgical debridement of the necrotic tissue, resuscitation of the patient, and the application of a broad spectrum of antibiotic therapy. We present the case of a 45-year-old male, referred to our department due to pain and swelling of the perineal region and scrotum, in the initial stage of Fournier's gangrene. The patient was hospitalized, a surgical incision and drainage of the areas affected by gangrene were made, and he underwent surgical treatment of the wound and intensive suppurative therapy for 23 days. After 23 days of hospitalization, the patient was discharged for home treatment with prior suturing of the incisional wounds, with an orderly local status and good general condition. Timely incision, debridement and application of intensive therapy in a condition such as Fournier's gangrene is of crucial importance. In this way, the possibility of potential complications, the progression of local to systemic disease, as well as the percentage of fatal outcome, is reduced.

References

1.
Boughanmi F, Ennaceur F, Korbi I, Chaka A, Noomen F, Zouari K. Fournier’s gangrene; its management remains a challenge. Vol. 38, Pan African Medical Journal.
2.
Smith, Bunker, Dinneen. Fournier’s gangrene. Vol. 81, British Journal of Urology. 1998. p. 347–55.
3.
Murphy M, Buckley M, Corr J, Vinayagamoorthy S, Grainger R, Mulcahy FM. Fournier’s gangrene of scrotum in a patient with AIDS. Vol. 67, Sexually Transmitted Infections. 1991. p. 339–41.
4.
Sarkis P, Farran F, Khoury R, Kamel G, Nemr E, Biajini J, et al. Gangrène de Fournier : revue de la littérature récente. Vol. 19, Progrès en Urologie. 2009. p. 75–84.
5.
Czymek R, Hildebrand P, Kleemann M, Roblick U, Hoffmann M, Jungbluth T, et al. New Insights into the Epidemiology and Etiology of Fournier’s Gangrene: A Review of 33 Patients. Vol. 37, Infection. 2009. p. 306–12.
6.
Ullah S, Khan M, Jan MAU. Fournier’s gangrene: A dreadful disease. Vol. 7, The Surgeon. 2009. p. 138–42.
7.
Morpurgo E, Galandiuk S. Fournier’s gangrene. Vol. 82, Surgical Clinics of North America. 2002. p. 1213–24.
8.
Chernyadyev SA, Ufimtseva MA, Vishnevskaya IF, Bochkarev YM, Ushakov AA, Beresneva TA, et al. Fournier’s Gangrene: Literature Review and Clinical Cases. Vol. 101, Urologia Internationalis. 2018. p. 91–7.
9.
Ephimenko NA, Privolnee. Fournier’s Gangrene. Vol. 10. 2008. p. 34–42.
10.
Pavlović B, Pavić J. Samoprocjena kvalitete života i rada medicinskih sestara/tehničara u Domu zdravlja Zagreb – centar. Vol. 8, Journal of applied health sciences. p. 269–80.
11.
Singh A, Ahmed K, Aydin A, Khan MS, Dasgupta P. Fournier’s gangrene. A clinical review. Vol. 88, Archivio Italiano di Urologia e Andrologia. p. 157.
12.
Thwaini A, Khan A, Malik A, Cherian J, Barua J, Shergill I, et al. Fournier’s gangrene and its emergency management. Vol. 82, Postgraduate Medical Journal. 2006. p. 516–9.
13.
Ferreira PC, Reis JC, Amarante JM, Silva ??lvaro Catarino, Pinho CJ, Oliveira IC, et al. Fournier???s Gangrene: A Review of 43 Reconstructive Cases. Vol. 119, Plastic and Reconstructive Surgery. 2007. p. 175–84.
14.
Montrief T, Long B, Koyfman A, Auerbach J. Fournier Gangrene: A Review for Emergency Clinicians. Vol. 57, The Journal of Emergency Medicine. 2019. p. 488–500.
15.
El-Qushayri AE, Khalaf KM, Dahy A, Mahmoud AR, Benmelouka AY, Ghozy S, et al. Fournier’s gangrene mortality: A 17-year systematic review and meta-analysis. Vol. 92, International Journal of Infectious Diseases. 2020. p. 218–25.
16.
Mallikarjuna MN, Vijayakumar A, Patil VS, Shivswamy BS. Fournier’s Gangrene: Current Practices. Vol. 2012, ISRN Surgery. 2012. p. 1–8.
17.
Mehl AA, Nogueira Filho DC, Mantovani LM, Grippa MM, Berger R, Krauss D, et al. Manejo da gangrena de Fournier: experiência de um hospital universitário de Curitiba. Vol. 37, Revista do Colégio Brasileiro de Cirurgiões. 2010. p. 435–41.
18.
Horta R, Cerqueira M, Marques M, Ferreira P, Reis J, Amarante J. Gangrena de Fournier: de urgencia urológica hasta el departamento de cirugía plástica. Vol. 33, Actas Urológicas Españolas. 2009. p. 925–9.
19.
Ersay A, Yilmaz G, Akgun Y, Celik Y. FACTORS AFFECTING MORTALITY OF FOURNIER’S GANGRENE: REVIEW OF 70 PATIENTS. Vol. 77, ANZ Journal of Surgery. 2007. p. 43–8.
20.
Femic M, Turkalj I, Dejanovic N. Fournier’s gangrene as a result of necrosis caused by urethral catheter. Vol. 9, PONS - medicinski casopis. 2012. p. 23–6.
21.
Kabay S, Yucel M, Yaylak F, Algin MC, Hacioglu A, Kabay B, et al. The clinical features of Fournier’s gangrene and the predictivity of the Fournier’s Gangrene Severity Index on the outcomes. Vol. 40, International Urology and Nephrology. 2008. p. 997–1004.
22.
Saifee NH, Evans HL, Magaret AS, Hess JR, Delaney M, O’Keefe GE, et al. Outcomes in necrotizing soft tissue infections treated with therapeutic plasma exchange. Vol. 57, Transfusion. 2017. p. 1407–13.
23.
Chawla SN, Gallop C, Mydlo JH. Fournier’s Gangrene: An Analysis of Repeated Surgical Debridement. Vol. 43, European Urology. 2003. p. 572–5.

Citation

Copyright

Article metrics

Google scholar: See link

The statements, opinions and data contained in the journal are solely those of the individual authors and contributors and not of the publisher and the editor(s). We stay neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Most read articles

Indexed by