<i><i>Fournier&#x2032;s gangrene</i></i> in Mansoura Egypt: A review of 74 cases

• Main Author: Ghnnam W
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2008-01-01
• Series: Journal of Postgraduate Medicine
• Subjects: Fournier&#x2032;s gangrene; idiopathic; necrotizing fascitis; outcome; perineal infections
• Online Access: http://www.jpgmonline.com/article.asp?issn=0022-3859;year=2008;volume=54;issue=2;spage=106;epage=109;aulast=Ghnnam

<b>Background:</b> Fournier&#x2032;s gangrene (FG), caused by synergistic aerobic and anaerobic organisms, is a life-threatening disorder in which infection of the perineum and scrotum (can affect penis alone) spreads along fascial planes, leading to soft-tissue necrosis. Despite antibiotics and aggressive debridement, the mortality rate of FG remains high. <b>Materials and Methods:</b> We analyzed 74 patients admitted to our institution&#x2032;s emergency surgical unit presenting with FG between January 2002 and January 2007, considering the anatomical site of infective gangrene, predisposing factors, etiological agents, and outcomes. <b>Results:</b> All the 74 patients included in this study were males; their mean age was 51&#x00B1;10.8 years (21-72 years). The mean duration from the onset of symptoms to admission to the hospital was 3.74&#x00B1;2.09 days (1-8 days). The mean hospitalization time was 9.2&#x00B1; 6.6 days (1-31). Forty patients (54.05&#x0025;) had FG secondary to anorectal conditions. No etiologic factors for FG were found in 27 patients (36.5&#x0025;). Diabetes mellitus as a predisposing factor was found in 38 patients (51.35&#x0025;). There was no definite predisposing factor in 24 patients (32.43&#x0025;). The microbiological finding was polymicrobial in 48 patients (64.8&#x0025;) and monomicrobial in 26 patients (35.1&#x0025;). The most frequent bacterial organisms were <i> Escherichia coli</i> (75.6&#x0025;). Simple sigmoid loop colostomy was done in one patient (1.4&#x0025;). Unilateral orchidectomy was done in one case (1.4&#x0025;). The overall mortality rate was 16 patients (21.6&#x0025;). <b>Conclusion:</b> FG is a rapidly progressive, fulminant infection. Even with aggressive surgical and medical treatment, mortality of the disease is high. In the present cases, such a high ratio of 21.6&#x0025; means that this disease is still serious and fatal in Egypt.