Introduction: Perineo-scrotal gangrene is a necrotizing fasciitis concerning soft parts of the genital area which necessitates a rapid, complete and multidisciplinary medical management. The aim of our study was to de...Introduction: Perineo-scrotal gangrene is a necrotizing fasciitis concerning soft parts of the genital area which necessitates a rapid, complete and multidisciplinary medical management. The aim of our study was to describe the epidemiologic, diagnostic and therapeutic aspects of Fournier’s gangrene. Patients and methods: We have carried out a retrospective study with 14 patients with Fournier’s gangrene, who were treated from January 2011 to November 2013 at the Urology A Department of Ibn Sina University Hospital, Rabat, Morocco. Results: The average age was 58 years (47 to 76 years). All patients were male. Average time (delay) between onset of infection and consultation was one week. Clinical symptomatology was dominated by edema and erythema signs, fever and pain. In most cases, skin necrosis initially affected perineo-scrotal region. 43% of patients were diabetic. 5 patients (35%) had a urethral stricture. The most common germs found were: Escherichia coli (50%), Streptococcus (22%) and Klebsiella (14%). The treatment consisted in a large debridement, associated with fluid and electrolyte replacement and parenteral broadspectrum antibiotics with drainage of urine. Orchiectomy was required in 2 patients. The average length of hospital stay was 3 weeks. 4 patients (28%) had a scrotal collection. 2 patients (14%) died from a toxic septic shock. Conclusion: Fournier’s gangrene remains, despite the multidisciplinary medical management, a serious affection associated with high mortality. Early consultation and correction of general disorders and immune deficiencies can improve its prognosis.展开更多
文摘Introduction: Perineo-scrotal gangrene is a necrotizing fasciitis concerning soft parts of the genital area which necessitates a rapid, complete and multidisciplinary medical management. The aim of our study was to describe the epidemiologic, diagnostic and therapeutic aspects of Fournier’s gangrene. Patients and methods: We have carried out a retrospective study with 14 patients with Fournier’s gangrene, who were treated from January 2011 to November 2013 at the Urology A Department of Ibn Sina University Hospital, Rabat, Morocco. Results: The average age was 58 years (47 to 76 years). All patients were male. Average time (delay) between onset of infection and consultation was one week. Clinical symptomatology was dominated by edema and erythema signs, fever and pain. In most cases, skin necrosis initially affected perineo-scrotal region. 43% of patients were diabetic. 5 patients (35%) had a urethral stricture. The most common germs found were: Escherichia coli (50%), Streptococcus (22%) and Klebsiella (14%). The treatment consisted in a large debridement, associated with fluid and electrolyte replacement and parenteral broadspectrum antibiotics with drainage of urine. Orchiectomy was required in 2 patients. The average length of hospital stay was 3 weeks. 4 patients (28%) had a scrotal collection. 2 patients (14%) died from a toxic septic shock. Conclusion: Fournier’s gangrene remains, despite the multidisciplinary medical management, a serious affection associated with high mortality. Early consultation and correction of general disorders and immune deficiencies can improve its prognosis.
