Fournier gangrene
| Fournier gangrene | |
|---|---|
48-year-old male with Fournier gangrene. Image shows the patient after full recovery and 3 days after ileostomy insertion.
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| Classification and external resources | |
| Specialty | Infectious disease |
| ICD-10 | N49.8 (ILDS N49.81), N76.8 |
| ICD-9-CM | 608.83 |
| DiseasesDB | 31119 |
| eMedicine | emerg/929 med/2814 |
| Patient UK | Fournier gangrene |
| MeSH | D018934 |
Fournier gangrene is a type of necrotizing fasciitis or gangrene usually affecting the perineum. It commonly occurs in elderly men, but it can also occur in women and children. It is more likely to occur in those with diabetes, alcoholics, or those who are immune compromised.
It was first described by Baurienne in 1764 and is named after a French venereologist, Jean Alfred Fournier following five cases he presented in clinical lectures in 1883.
Contents
Cause
In the majority of cases Fournier gangrene is a mixed infection caused by both aerobic and anaerobic bacteria.[1] Death can result from Fournier gangrene.[2]
Treatment
Fournier gangrene is a urological emergency requiring intravenous antibiotics and debridement (surgical removal) of necrotic (dead) tissue. In addition to surgery and antibiotics, hyperbaric oxygen therapy (HBOT) may be useful and acts to inhibit the growth of and kill the anaerobic bacteria.[3] Despite such measures, the mortality rate overall is 40%, but 78% if sepsis is already present at the time of initial hospital admission.[4]
Epidemiology
An estimated 750 cases have been reported in the literature,[5] with most people in their 60s or 70s with other illnesses.[6] According to another study in 2000, there have been at least 1726 reported cases in the English literature.[7] However, Fournier gangrene is not a reportable illness, so the number of unreported cases is unclear. A similar infection in women has been occasionally described.[8]
In Turkey it was reported that 46% of patients had diabetes mellitus[4] while other studies have identified approximately a third of patients having either diabetes, alcoholism or malnutrition, and 10% having medical immunosuppression (chemotherapy, steroids, or malignancy).[9]
Notable cases
The most historically prominent sufferers from this condition may have been Herod the Great, his grandson Herod Agrippa, and possibly the Roman emperor Galerius. Puerto Rican abolitionist and pro-independence leader Segundo Ruiz Belvis died from Fournier gangrene in November 1867.[citation needed]
See also
References
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