Yuda Junichiro, Honma Riko, Yahagi Tomoyasu, Omoto Eijiro
Department of Hematology, Yamagata Prefectural Central Hospital, Japan.
Intern Med. 2011;50(18):2015-9. doi: 10.2169/internalmedicine.50.5323. Epub 2011 Sep 15.
We report the case of a 68-year-old man who was diagnosed with Fournier's gangrene (FG), which developed during immunosuppresive treatment for idiopathic thrombocytopenic purpura (ITP). The patient was administered steroids for ITP but on the 36th day, he developed FG and septic shock. We initiated antibiotic treatment and drained a periproctal abscess immediately. On day 53, extensive drainage to progressive FG and a splenectomy was performed, following which both FG and thrombocytopenia improved. This is the first case of FG has developing in a ITP patient. It appears that high-dose immunoglobulin therapy and splenectomy should be considered earlier especially for a patient complicated with FG.
我们报告了一例68岁男性患者,他被诊断为福尼尔坏疽(FG),该病在特发性血小板减少性紫癜(ITP)免疫抑制治疗期间发生。该患者因ITP接受类固醇治疗,但在第36天,他出现了FG和感染性休克。我们立即开始抗生素治疗并引流了直肠周围脓肿。在第53天,对进展性FG进行了广泛引流并实施了脾切除术,此后FG和血小板减少症均有所改善。这是首例FG发生于ITP患者的病例。似乎对于合并FG的患者,应更早考虑高剂量免疫球蛋白治疗和脾切除术。