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KMID : 1234520080030020215
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Korean Journal of Urogenital Tract Infection Inflammation
2008 Volume.3 No. 2 p.215 ~ p.220
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Clinical Analysis of Fournier’s Gangrene 9 Cases
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Kim Jung-Dam
Kim Ki-Ho
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Abstract
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Purpose: Fournier’s gangrene is a rare and rapidly progressive infection of the genitalia, perineum, and abdominal wall. The mortality rate from this infection ranges from 0 to 67 percent. One of the most important determinants of the overall outcome is early recognition and extensive surgical debridement combined with broad-spectrum antibiotics therapy. The aim of this study was to review the clinical outcomes of 9 consecutive patients who suffered with Fournier’s gangrene and the related medical literature to highlight the current status of this disease.
Materials and methods: We retrospectively reviewed the medical records of 9 patients with the Fournier’s gangrene who had been treated at Dong-guk University Hospital between March 1999 and December 2007.
Results: The mean age was 60 years (range: 38~82), and the male to female ratio was 8:1. The most common cause of Fournier’s gangrene was perianal abscess (n=6, 66.6%) and the most common disease associated with Fournier’s gangrene was diabetes mellitus (n=5, 55.5%). The most common cultured organisms were K pneumoniae and E. coli. We performed aggressive surgical debridement combined with broad spectrum antibiotics therapy. The potential ports of entry for the causuative bacteria were anorectum (66%), urinary tract (22%) and skin (11%) The number of surgical procedures per patient ranged between 1 and 7 (mean: 3.54). Diverting colostomy was required in 22.2% (n=2) of the cases. One of them had multiple debridement at the thigh. Suprapubic cystostomy and both orchiectomies were performed in 1patient, respectively. One patient died due to sepsis.
Conclusions: Fournier’s gangrene is a life-threatening disease, but the mortality rate can be diminished via early diagnosis and aggressive surgical intervention. And the use of broadspectrum antibiotics is mandatory.
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KEYWORD
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Fournier’s gangrene, Necrotizing fascitis, Infection
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