The evaluation of microbiology and prognosis of fournier’s gangrene in past five years

Tang, Lap-Ming; Su, Yu‐Jang; Lai, Ying–Cheng

doi:10.1186/s40064-014-0783-8

Cited by 68 publications

(44 citation statements)

References 20 publications

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“…However, this aging trend seems to be related to the incidence of FG with an increasing number of predisposing disease. Similar to our results, males are more common to suffer from FG than females, with the reported male-to-female ratio of 5.3:1 [5]. This sex distribution appears to be associated with the anatomical difference.…”

Section: Discussionsupporting

confidence: 91%

A retrospective case series of Fournier’s gangrene: necrotic fasciitis in perineum and crissum

Zhang

et al. 2020

Preprint

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BackgroundTo describe the clinical characteristics and management for Fournier’s gangrene. Experience summary and literature references are provided for future treatment improvement.MethodsWe retrospectively reviewed the cases diagnosed with Fournier’s gangrene in our department from June 2016 to June 2019. Clinical data, including manifestation, diagnosis, treatment and outcomes for Fournier’s gangrene were presented.ResultsThere were 12 patients enrolled in this paper, with the average age of 60 years old. It showed a male predominance with male-to-female ratio of 6:1. The average of LRINEC score of 10.1. Diabetes mellitus was the main predisposing disease. 11 patients received emergency debridement and 1 patient died of sepsis on the 2nd day after admission. The mortality rate was 8.3%. 6 cases developed complications, including sepsis, pneumonia, renal and heart failure. NPWT was applied in 10 cases, while the rest 1 received normal daily dressing changes because of fecal contamination. Flaps were utilized in 2 patients to cover the defect, including one with advancement flap and one with pudendal-thigh flap, while others received secondary suture, secondary healing, skin graft or combined management. No relapse was observed during the follow-up visits.ConclusionsFournier’s gangrene is a life-threatening infection that requires early diagnosis and surgery intervention. The predisposing disease, clinical manifestation and LRINEC score should be taken into comprehensive consideration, which is helpful for timely diagnosis. Moreover, further successful treatment depends on the aggressive debridement, broad-spectrum antibiotics therapy, wound management and closure choice.

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Section: Discussionsupporting

confidence: 91%

A retrospective case series of Fournier’s gangrene: necrotic fasciitis in perineum and crissum

Zhang

et al. 2020

Preprint

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“…A recent report from North America reports a lower mortality of 11.1%. [6] The mortality from studies done in other African countries range from 3.6% to 24%. [7,8,9] A recent 3 year review study on 20 patients from Saudi Arabia recorded zero mortality.…”

Section: Discussionmentioning

confidence: 99%

Fournier's gangrene: outcome analysis and prognostic factors

Meki¹,

Mangwiro²,

Lazarus³

2018

S. Afr. j. surg.

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Background: Fournier's gangrene is an infective necrotising fasciitis of the external genitalia and perineum associated with significant morbidity and mortality. The factors associated with non survival have been described but are not universally accepted. The identification of prognostic factors remains critical to improve outcomes. Objectives: To determine the hospital based mortality and factors associated with non-survival among subjects with a clinical diagnosis of Fournier's gangrene. Methods: A prospective hospital based observational study on 51patients with a clinical diagnosis of Fournier's gangrene over a 2-year period. A comparison was made between survivors and non-survivors to establish prognostic factors associated with non survival. Results: The disease related hospital mortality was 27% (14/51). The mean age of the 51, all male patients was 47 years. An older age was significantly associated with non-survival (p=0.02). The presence of renal dysfunction (p=0.001), severe sepsis (p=0.000), delay in surgical debridment (p=0.04), urogenital source of infection (p=0.01), a body surface area involvement of greater than 5% (p=0.006), abdominal wall involvement (p=0.02) on admission were significant factors associated with mortality. The presence of either HIV infection or diabetes mellitus was not a prognostic indicator of mortality. The clinical and biochemical parameters on admission associated with non survival were a high respiratory rate (p=0.03), a low hemoglobin(p=0.0001), an elevated blood urea nitrogen (p=0.005) and creatinine (p=0.01). Multivariate logistic regression analysis did not show any independent factors associated with non survival. Conclusion: Fournier's gangrene remains a fatal condition with a hospital mortality of 27%. Prognostic factors for non survival include an advanced age, a urogenital source of infection, abdominal involvement, severe sepsis and renal dysfunction.S Afr J Surg 2018;56 (3) http://dx.

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“…6 Afecta a hombres y mujeres, con franco predominio en el sexo masculino, y su frecuencia es baja en pediatría. 7 La enfermedad comienza con una infección del tejido celular subcutáneo por bacterias productoras de toxinas, las cuales generan una lesión tisular que afecta a todas las capas de la piel hasta producir una fascitis. Posteriormente, se desarrolla una endoarteritis obliterante, responsable de la trombosis vascular y de la necrosis tisular consecuente.…”

Section: Discussionunclassified

“…8 Con respecto a los agentes causales, se trata de una infección polimicrobiana en un 50-80 % de los casos, según las series analizadas. 7,9 Escherichia coli es el germen hallado con mayor frecuencia. Otros patógenos incluyen Streptococcus, Bacteroides, Enterobacter, Staphylococcus, Enterococcus, Pseudomonas, Corynebacterium, Klebsiella pneumoniae y Candida albicans.…”

Section: Discussionunclassified

“…Otros patógenos incluyen Streptococcus, Bacteroides, Enterobacter, Staphylococcus, Enterococcus, Pseudomonas, Corynebacterium, Klebsiella pneumoniae y Candida albicans. 7,9 En los últimos años, se han reportado casos originados por gérmenes resistentes, tales como Staphylococcus aureus meticilino resistente o E. coli productora de betalactamasas. 10 En el caso del paciente descrito, se aisló S. marcescens en el cultivo del tejido necrótico, pero se decidió mantener el esquema antibiótico de amplio espectro debido a la elevada frecuencia de infección polimicrobiana reportada en la literatura.…”

Section: Discussionunclassified

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Gangrena de Fournier en un niño con síndrome nefrótico corticorresistente. A propósito de un caso

et al. 2020

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Presentación de casos clínicos RESUMEN La gangrena de Fournier es una fascitis necrotizante que afecta las regiones genital, perineal y perianal, de inicio súbito y diseminación rápidamente progresiva. Su diagnóstico obliga a una urgente intervención interdisciplinaria. La asociación con enfermedades nefrológicas es rara. Se presenta un caso de gangrena de Fournier en un niño con síndrome nefrótico corticorresistente y anasarca con edema escrotal grave. Recibió un esquema antibiótico de amplio espectro y se realizó un desbridamiento quirúrgico extenso e inmediato de la lesión necrótica. Posteriormente, requirió reparación por parte de Cirugía Plástica. Presentó una respuesta clínica favorable a la terapéutica instaurada.

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The evaluation of microbiology and prognosis of fournier’s gangrene in past five years

Cited by 68 publications

References 20 publications

A retrospective case series of Fournier’s gangrene: necrotic fasciitis in perineum and crissum

A retrospective case series of Fournier’s gangrene: necrotic fasciitis in perineum and crissum

Fournier's gangrene: outcome analysis and prognostic factors

Gangrena de Fournier en un niño con síndrome nefrótico corticorresistente. A propósito de un caso

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