Fatal infections in andrology. Atypical clinical presentation of a Fournier’s disease

Olivieri, Valerio; Ruggiero, Gabriele; Abate, Danilo; Serra, Nicoletta; Fortunati, Valentina; Griffa, D; Forte, Flavio; Corongiu, Emanuele

doi:10.4081/aiua.2020.3.213

Cited by 3 publications

(2 citation statements)

References 40 publications

(2 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The rapid progression of FG is linked to impaired cellular immunity, which permits suppurative bacterial infection, and the synergetic polymicrobial nature, which causes a substantial release of bacterial toxins. Eventually, small subcutaneous vessels experience obliterative thrombosis, resulting in gangrene of the involved struc- tures (1,9). The bacterial access usually results from a cutaneous breakdown (e.g., local trauma) or the spread of urinary or perineal infections.…”

Section: Discussionmentioning

confidence: 99%

Treatment outcome of Fournier's gangrene and its associated factors: A retrospective study

Alkohlany

Baker²,

Ahmed

et al. 2023

Arch Ital Urol Androl

View full text Add to dashboard Cite

Introduction: Fournier's gangrene (FG) is a rapidly progressive necrotizing infection that affects the perineal and abdominal regions and is known for its high mortality rate. This study aims to present the practical experience of managing FG patients and identify factors that may affect their clinical outcomes. Materials and methods: A retrospective study was conducted from April 2009 to December 2020 at General Military Hospital in Sana'a, Yemen including 26 patients who were diagnosed with FG and treated on. Data on demographic characteristics, time to admission, surgical intervention, and treatment outcomes were collected. Univariate analysis was performed to determine factors that affect patient outcomes. Result: The mean age of the patients was 65.77 ± 5.04 years, and 65.4% of them were over the age of 65. Most patients (57.7%) presented after five days of experiencing symptoms, and 65.4% were in septic conditions. Of the patients, 17 (65.4%) survived, and the total mortality rate was 34.6%. Univariate analysis showed that delayed presentation (p = 0.001), a history of diabetes mellitus (p < 0.001), end-stage renal disease (p < 0.001), heart failure (p < 0.001), cerebrovascular accident (p = 0.032), liver cirrhosis (p < 001), presence of multiple comorbidities (p < 001), involvement of lager area (p < 001), septic conditions (p = 0.009), advanced age (p = 0.018), and intensive care unit admission (p = 0.002) were found to be risk factors for mortality in patients with FG. Conclusions: FG is a potentially life-threatening medical condition, even with aggressive and specialized treatment. Our study revealed a mortality rate of 34.6%. Factors such as older age, the presence of multiple comorbidities, septic conditions, the abdominal spread of the disease, intensive care unit admission, and delayed presentation contribute to higher mortality rates.

show abstract

Section: Discussionmentioning

confidence: 99%

Treatment outcome of Fournier's gangrene and its associated factors: A retrospective study

Alkohlany

Baker²,

Ahmed

et al. 2023

Arch Ital Urol Androl

View full text Add to dashboard Cite

show abstract

“…Fournier's gangrene is a life-threatening condition, constituting a urological surgical emergency and has a high mortality rate, ranging from 0 to 67% [ 4 ]. Risk factors for the disease are intravenous drug abuse [ 5 ], radiotherapy [ 6 ], diabetes [ 7 ], cancer, and iatrogenic factors [ 8 – 10 ]. Triggers relating to the exclusive penile zone have been identified as the self-injection of Vaseline in the penis' shaft [ 11 ], self-introduction of beads in the urethra [ 12 ], Phimosis complication [ 13 ], penile abrasion from oral sex [ 3 ], infection by atypical Candida species [ 14 ], and Calciphylaxis [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

A Retrospective Case Series in Fournier’s Disease: And Its Emergency Management et Grafting Technique for Penis Coverage

Tripodi

Guastafierro²,

Gagliardi

et al. 2022

Emergency Medicine International

Self Cite

View full text Add to dashboard Cite

Fournier’s gangrene is a necrotizing soft tissue infection of the genital, perineal, and perirectal areas. A primary isolated involvement of the penis is rare, but it can be affected in some circumstances. The purpose of this case series is to present the findings of our thirteen years’ experience in the reconstruction of the penis in Fournier’s gangrene and our full-thickness grafting technique to cover the penis rod. We retrospectively reviewed patient data who underwent a penis reconstruction following Fournier’s gangrene in 2018. The data was analyzed to report the estimated percentage of complications, of patients with primary or secondary gangrene of the penis, the number of reinterventions, and finally the percentage of deaths or recovery. 23 patients underwent reconstruction with our technique of full-thickness skin graft. In all cases, the skin graft was harvested from the upper arm with an arrow shape mark. No further penile revision surgery was required, and neither patient complained about retraction, nor traction, or pain during erection. The donor site healed without any complications. We believe that the coverage of the penis using our grafting technique is safe, easily reproducible, and demonstrates excellent esthetic and functional results.

show abstract

Fournier’s Gangrene Surgical Reconstruction: A Systematic Review

Susini,

Marcaccini,

Efica

et al. 2024

JCM

View full text Add to dashboard Cite

Fournier’s gangrene (FG) is a rare form of necrotizing fasciitis of the perineal, genital, or perianal region. It is characterized by an aggressive course and high mortality rate, over 20%. FG demands immediate treatment including resuscitation maneuvers, intravenous antibiotic therapy and early surgical debridement. Background/Objectives: The gold-standard treatment for FG is surgical reconstruction. However, up to date, no precise guidelines exist. Thus, we decided to systematically review the literature, focusing on FG contemporary approaches to reconstructive surgery, aiming to analyze the various reconstructive strategies and their specific indications. Methods: A systematic review was carried out according to the PRISMA statement by searching various databases from April 2014 to April 2024, using the terms ‘‘Fournier Gangrene OR Fournier Gangrene Reconstruction OR Fournier Gangrene Treatment OR Fournier Gangrene Plastic Surgery OR Necrotizing Fasciitis OR Necrotizing Fasciitis AND Reconstruction”. The eligibility criteria included original studies aimed at discussing FG reconstruction with at least three clinical cases. Results: The final synthesis included 38 articles, and 576 reconstructions were described. Of these, 77.6% were minimally invasive strategies (direct closure, secondary healing, grafts, and local random flaps), while more invasive reconstructions (loco-regional flaps based on known vascular anatomy) were adopted in 22.4%. No free flaps were reported. Conclusions: FG requires immediate medical interventions including broad-spectrum antibiotic therapy, surgical debridement, adjuvant therapies, and reconstructive surgeries. Taking into account the anatomical characteristics of the inguinal-crural region, skin grafts and local random flaps could offer versatile and effective reconstructions for most FG cases, while the more invasive strategies should be reserved for very few cases. Future research is warranted to define an FG dedicated reconstruction protocol.

show abstract

Fatal infections in andrology. Atypical clinical presentation of a Fournier’s disease

Cited by 3 publications

References 40 publications

Treatment outcome of Fournier's gangrene and its associated factors: A retrospective study

Treatment outcome of Fournier's gangrene and its associated factors: A retrospective study

A Retrospective Case Series in Fournier’s Disease: And Its Emergency Management et Grafting Technique for Penis Coverage

Fournier’s Gangrene Surgical Reconstruction: A Systematic Review

Contact Info

Product

Resources

About