Ji Hongjian, Shen Wei, Zhou Xiaohua, Zhang Linlin, Zhao Xin, Tang Qinfang, Guo Cheng
Department of Pharmacy, Jiangsu Vocational College of Medicine, Jiangsu, People's Republic of China.
Department of Pharmacy, Suqian Hospital, Jiangsu Province Hospital, Jiangsu, People's Republic of China.
Heliyon. 2024 Jun 18;10(12):e33244. doi: 10.1016/j.heliyon.2024.e33244. eCollection 2024 Jun 30.
is an uncommon Clostridium but is one of the essential anaerobic bacteria that makes up the intestinal microbiota. A highly variable body temperature, the white blood cell count, or an elusory prognosis can reflect infection, especially in patients with Fournier's gangrene. Fournier's gangrene is a rare soft-tissue infection with necrosis that occurs mainly in the perianal and genital regions, males being more susceptible. Here, we report a 70-year-old Chinese man with Fournier's gangrene and high levels interleukins who suffered from infection, identified and verified by matrix-assisted laser desorption ionization/time-of-flight mass spectrometry (MALDI-TOF MS) and 16S rRNA sequencing. Fournier's gangrene severity index (FGSI) of the patient was measured once the patient was admitted to hospital. His FGSI was 6, indicating no abnormal condition. He had abnormally high interleukin (IL)-6, IL-8, and IL-10 levels, associated with severe inflammatory conditions. Despite the patient's resuscitation and standardized treatment with antimicrobial drugs, the symptoms did not improve. The patient's condition deteriorated, and he died on hospitalization day 5. Abnormally elevated IL-6, IL-8, and IL-10 levels were a novel finding in a case of infection, leading to Fournier's gangrene. In the present case, a perianal abscess was the predisposing condition for Fournier's gangrene. Close attention should be paid to the isolation and identification of pathogenic during the bacteriological examination of patients with perianal abscesses. IL-6, IL-8, and IL-10 may be critical biomarkers that supplement the FGSI for diagnosing infection leading to Fournier's gangrene in immunosuppressed persons.
是一种不常见的梭状芽孢杆菌,但却是构成肠道微生物群的重要厌氧菌之一。体温高度可变、白细胞计数或难以捉摸的预后可反映感染情况,尤其是在患有福尼尔坏疽的患者中。福尼尔坏疽是一种罕见的伴有坏死的软组织感染,主要发生在肛周和生殖器区域,男性更易感染。在此,我们报告一名70岁的中国男性,患有福尼尔坏疽且白细胞介素水平高,遭受感染,通过基质辅助激光解吸电离/飞行时间质谱(MALDI-TOF MS)和16S rRNA测序进行鉴定和验证。患者入院后即测量其福尼尔坏疽严重程度指数(FGSI)。他的FGSI为6,表明无异常情况。他的白细胞介素(IL)-6、IL-8和IL-10水平异常升高,与严重炎症状态相关。尽管对患者进行了复苏并使用抗菌药物进行了标准化治疗,但症状并未改善。患者病情恶化,于住院第5天死亡。IL-6、IL-8和IL-10水平异常升高是感染导致福尼尔坏疽病例中的一个新发现。在本病例中,肛周脓肿是福尼尔坏疽的诱发因素。在对肛周脓肿患者进行细菌学检查时,应密切关注病原菌的分离和鉴定。IL-6、IL-8和IL-10可能是补充FGSI用于诊断免疫抑制人群中导致福尼尔坏疽的感染的关键生物标志物。