Sudden unexpected death due to Fournier gangrene

Majdoub, Wael; Mosbahi, Amal; Bonbled, Frédéric

doi:10.1007/s12024-018-0030-7

Cited by 4 publications

(1 citation statement)

References 12 publications

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“…4 Predisposing factors for Fournier gangrene include obesity, diabetes mellitus, alcoholism, smoking, hypertension, chronic kidney disease, perianal trauma and immunosuppressive conditions. 5 Based on those mentioned above, this case report aims to evaluate the recent management of a patient with Type 2 Diabetes Mellitus (T2DM) with Fournier gangrene at Dr. Sutomo General Hospital, Surabaya, Indonesia.…”

Section: Introductionmentioning

confidence: 99%

A patient with Type 2 Diabetes Mellitus (T2DM) with Fournier gangrene: a case report

2022

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Background: Fournier gangrene is necrotizing fasciitis of the genitalia and perineum that can extend to the abdominal wall, gluteus or lower extremities. Predisposing factors for Fournier gangrene include obesity, diabetes mellitus (DM), alcoholism, smoking, hypertension, chronic kidney disease, perianal trauma and immunosuppressive conditions. This case report aims to evaluate the management of Fournier gangrene on metabolic and surgical treatmentCase Presentation: A-53 years old-female with Type 2 Diabetes Mellitus (T2DM) came to the Emergency Ward of Dr. Sutomo General Hospital, Surabaya, with the chief complaint of sores on the buttocks for 1 week. The patient was diagnosed with Fournier gangrene. On physical examination in the room, erythematous macular lesions were found in the folds of the breast and armpit on chest examination. Obtained scratch marks were found because the patient is often scratched. The wound from the buttock and keep enlarged due to the Fournier gangrene ( necrotizing infection). In this case, the patient was given the antibiotics ceftriaxone and metronidazole. The patient died during the 8th day of treatment due to a suspected septic shock.Conclusion: Surgical management in this patient is debridement. Multi-disciplinary management of obstetrics, urology, digestive surgery, and plastic surgery is required for the management of Fournier gangrene in T2DM patients

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Section: Introductionmentioning

confidence: 99%

A patient with Type 2 Diabetes Mellitus (T2DM) with Fournier gangrene: a case report

2022

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Endocrinology and Diabetes in the Elder

Lévy¹

2020

Geriatric Forensic Medicine and Pathology

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Management of Fournier’s gangrene during the Covid-19 pandemic era: make a virtue out of necessity

Paladini

Cochetti

Tancredi

et al. 2022

Basic Clin. Androl.

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Background Fournier’s gangrene (FG) is a necrotizing fasciitis caused by aerobic and anaerobic bacterial infection that involves genitalia and perineum. Males, in their 60 s, are more affected with 1.6 new cases/100.000/year. Main risk factors are diabetes, malignancy, inflammatory bowel disease. FG is a potentially lethal disease with a rapid and progressive involvement of subcutaneous and fascial plane. A multimodal approach with surgical debridement, antibiotic therapy, intensive support care, and hyperbaric oxygen therapy (HBOT) is often needed. We present the inpatient management of an FG case during the Covid-19 pandemic period. A narrative review of the Literature searching “Fournier’s gangrene”, “necrotizing fasciitis” on PubMed and Scopus was performed. Case presentation A 60 years old man affected by diabetes mellitus, with ileostomy after colectomy for ulcerative colitis, was admitted to our Emergency Department with fever and acute pain, edema, dyschromia of right hemiscrotum, penis, and perineal region. Computed tomography revealed air-gas content and fluid-edematous thickening of these regions. Fournier’s Gangrene Severity Index was 9. A prompt broad-spectrum antibiotic therapy with Piperacillin/Tazobactam, Imipenem and Daptomycin, surgical debridement of genitalia and perineal region with vital tissue exposure, were performed. Bedside daily surgical wound medications with fibrine debridement, normal saline and povidone-iodine solutions irrigation, iodoform and fatty gauze application, were performed until discharge on the 40th postoperative day. Every 3 days office-based medication with silver dressing, after normal saline and povidone-iodine irrigation and fibrinous tissue debridement, was performed until complete re-epithelialization of the scrotum on the 60th postoperative day. Conclusions FG is burdened by a high mortality rate, up to 30%. In the literature, HBOT could improve wound restoration and disease-specific survival. Unfortunately, in our center, we do not have HBOT. Moreover, one of the pandemic period problems was the patient’s displacement and outpatient hospital management. For all these reasons we decided for a conservative inpatient management. Daily cleaning of the surgical wound allowed to obtain its complete restoration avoiding surgical graft and hyperbaric oxygen chamber therapy, without foregoing optimal outcomes.

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Sudden unexpected death due to Fournier gangrene

Cited by 4 publications

References 12 publications

A patient with Type 2 Diabetes Mellitus (T2DM) with Fournier gangrene: a case report

A patient with Type 2 Diabetes Mellitus (T2DM) with Fournier gangrene: a case report

Endocrinology and Diabetes in the Elder

Management of Fournier’s gangrene during the Covid-19 pandemic era: make a virtue out of necessity

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