Fournier gangrene

Infobox_Disease
Name = Fournier gangrene


Caption =
DiseasesDB = 31119
ICD10 = ICD10|N|49|8|n|40 (ILDS N49.81), ICD10|N|76|8|n|70
ICD9 = ICD9|608.83
ICDO =
OMIM =
MedlinePlus =
eMedicineSubj = emerg
eMedicineTopic = 929
eMedicine_mult = eMedicine2|med|2814
MeshID = D018934

Fournier gangrene is a type of necrotizing infection (gangrene) usually affecting the male genitals. It is a type of necrotizing fasciitis.

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.

Etiology

In the majority of cases Fournier gangrene is a mixed infection caused by both aerobic and anaerobic bacteria. [cite journal |author=Thwaini A, Khan A, Malik A, Cherian J, Barua J, Shergill I, Mammen K |title=Fournier's gangrene and its emergency management |journal=Postgrad Med J |volume=82 |issue=970 |pages=516–9 |year=2006 |pmid=16891442 |doi=10.1136/pgmj.2005.042069]

Incidence

Only 600 cases of Fournier gangrene were reported in the world literature in the ten years since 1996, with most patients in their 60s or 70s with other concurrent illnesses. [cite journal |author=Vaz I |title=Fournier gangrene |journal=Trop Doct |volume=36 |issue=4 |pages=203–4 |year=2006 |pmid=17034687 |doi=10.1258/004947506778604724] However, Fournier's gangrene is not a reportable illness, and the condition is not uncommon, especially among diabetic individuals. A similar infection in women has been occasionally described. [cite journal |author=Herzog W |title= [Fournier gangrene--also in females?] |journal=Zentralbl Chir |volume=112 |issue=9 |pages=564–76 |year=1987 |pmid=2956804 ]

In Turkey it was reported that 46% of patients had diabetes mellituscite journal |author=Yanar H, Taviloglu K, Ertekin C, Guloglu R, Zorba U, Cabioglu N, Baspinar I |title=Fournier's gangrene: risk factors and strategies for management |journal=World J Surg |volume=30 |issue=9 |pages=1750–4 |year=2006 |pmid=16927060 |doi=10.1007/s00268-005-0777-3] whilst other studies have identified approximately a third of patients having either diabetes, alcoholism or malnutrition, and 10% having medical immunosuppression (chemotherapy, steroids, malignancy). [cite journal |author=Tahmaz L, Erdemir F, Kibar Y, Cosar A, Yalcýn O |title=Fournier's gangrene: report of thirty-three cases and a review of the literature |journal=Int J Urol |volume=13 |issue=7 |pages=960–7 |year=2006 |pmid=16882063 |doi=10.1111/j.1442-2042.2006.01448.x]

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 (HBO) is used and acts to inhibit the growth of and kill the anaerobic bacteria. [cite journal |author=Zamboni WA, Riseman JA, Kucan JO |title=Management of Fournier's Gangrene and the role of Hyperbaric Oxygen |journal=J. Hyperbaric Med |volume=5 |issue=3 |pages=177–186 |year=1990 |url=http://archive.rubicon-foundation.org/4431 |accessdate=2008-05-16] Despite such measures, the mortality rate overall is 40%, but 78% if sepsis is already present at the time of initial hospital admission.

The most historically prominent sufferers from this condition may have been Herod the Great, and possibly the Roman emperor Galerius. Puerto Rican abolitionist and pro-independence leader Segundo Ruiz Belvis died from Fournier gangrene in 1868.

References

External links

* and WhoNamedIt|doctor|2209|Jean Alfred Fournier