Molla Yohannis Derbew, Assefa Mezgebu Alemneh, Abraha Aklilu Yiheyis
Department of Surgery, University of Gondar, Collage of Medicine and Health Sciences, Gondar, Ethiopia.
Department of Surgery, University of Gondar, Collage of Medicine and Health Sciences, Gondar, Ethiopia.
Int J Surg Case Rep. 2023 Apr;105:107984. doi: 10.1016/j.ijscr.2023.107984. Epub 2023 Mar 20.
Fournier's gangrene (FG) is a polymicrobial, both aerobic and anaerobic, synergistic necrotizing fasciitis of the perineal, genital, or perianal regions. It is a rapidly progressive and fulminant soft tissue infection and it is potentially fatal. Fournier's gangrene has been shown to be strongly associated with diabetes, chronic alcoholism, human immunodeficiency virus (HIV), lymphoproliferative diseases, chronic steroid abuse, and cytotoxic drugs.
A 25-year-old Ethiopian male patient with no previous medical history presented to the emergency department with a four-day history of perineal pain, swelling, and discharge. Associated with this he had a high-grade fever and one episode of vomiting of ingested matter. On examination, he was febrile, tachycardic, and hypotensive. He had a grossly necrotic scrotum and palpable crepitus extending to the left lower anterior abdominal wall.
On investigations, he had elevated leukocyte count, random blood sugar, low hemoglobin, and elevated creatinine levels. Subsequently, the patient was admitted and was started with broad-spectrum antibiotics and multiple debridements were done along with other supportive measures. Finally, the patient was discharged improved after 17 days of hospital stay.
Fournier's gangrene is a rapidly progressive, fulminant infection. Nevertheless, prompt diagnosis can be difficult and requires a high index of suspicion. Early diagnosis and appropriate management have paramount importance in reducing mortality and morbidity in these patients.
福尼尔坏疽（FG）是一种多微生物感染，包括需氧菌和厌氧菌，是会阴、生殖器或肛周区域的协同坏死性筋膜炎。它是一种快速进展且暴发性的软组织感染，有潜在致命性。福尼尔坏疽已被证明与糖尿病、慢性酒精中毒、人类免疫缺陷病毒（HIV）、淋巴增殖性疾病、慢性类固醇滥用和细胞毒性药物密切相关。
一名25岁无前科病史的埃塞俄比亚男性患者因会阴疼痛、肿胀和分泌物增多4天就诊于急诊科。与此相关的是，他有高热和一次呕吐所摄入物质的情况。检查时，他发热、心动过速且血压降低。他阴囊严重坏死，可触及捻发音，范围延伸至左下前腹壁。
检查发现，他白细胞计数升高、随机血糖升高、血红蛋白降低以及肌酐水平升高。随后，患者入院，开始使用广谱抗生素，并进行了多次清创以及其他支持治疗。最终，患者住院17天后好转出院。
福尼尔坏疽是一种快速进展的暴发性感染。然而，及时诊断可能困难，需要高度怀疑指数。早期诊断和适当管理对于降低这些患者的死亡率和发病率至关重要。
