scholarly journals An unusual case of malignant mesothelioma mimicking as Fournier’s gangrene

Author(s):  
Geoffrey E. Sundar ◽  
Kishan Prasad Hosapatna Laxminarayana ◽  
Jayaprakash Kubalady Shetty ◽  
Lancelot Lobo

Fournier gangrene is a rare, life-threatening necrotizing fasciitis that usually involves the perineal or genital areas. Malignant mesothelioma in the inguinal and paratesticular region is a very rare entity and manifesting as Fournier’s gangrene is still rare. Here we present a case of malignant mesothelioma which presented clinically as Fournier’s gangrene.  

ISRN Surgery ◽  
2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
M. N. Mallikarjuna ◽  
Abhishek Vijayakumar ◽  
Vijayraj S. Patil ◽  
B. S. Shivswamy

Fournier’s gangrene is an acute, rapidly progressive, and potentially fatal, infective necrotizing fasciitis affecting the external genitalia, perineal or perianal regions, which commonly affects men, but can also occur in women and children. There has been an increase in number of cases in recent times. Despite advanced management mortality is still high and averages 20–30%. Early diagnosis using Laboratory Risk Indicator for Necrotizing Fasciitis score and stratification of patients into high risk category using Fournier's Gangrene Severity Index score help in early initiation of treatment. Triple antibiotic combined with radical debridement is the mainstay of treatment. There have been many advances in management of Fournier gangrene including use of vaccum assisted closure and hyperbaric oxygen therapy. With introduction of newer devices like Flexi-Seal, fecal diversion can be done, avoiding colostomy. Reconstruction of perineal defects using skin grafts, flaps, and urethral reconstruction using gracilis flaps can reduce the morbidity associated with FG and provide acceptable functional and aesthetic outcomes.


2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Jason D. Heiner ◽  
Katisha D. Eng ◽  
Todd A. Bialowas ◽  
Diane Devita

Fournier's gangrene is a rare and often fulminant necrotizing fasciitis of the perineum and genital region frequently due to a synergistic polymicrobial infection. This truly emergent condition is typically seen in elderly, diabetic, or otherwise immune-compromised individuals. Here, we report an unusual case of Fournier's gangrene due to excessive masturbation in an otherwise healthy 29-year-old male who presented to the emergency department complaining of two days of fever, vomiting, and diffuse myalgias. Upon further questioning, he also endorsed severe scrotal pain and swelling and frequent masturbation with soap as a lubricant resulting in recurrent penile erythema and minor skin abrasions. Examination of the patient's perineum was consistent with Fournier's gangrene and included significant erythema, edema, and calor of the penis and scrotum with a large malodorous eschar. He was given intravenous antibiotics and immunoglobulin and promptly underwent three surgical debridements of the scrotum and penis with split-thickness skin grafting. Complications from excessive masturbation are exceedingly rare, but as this case illustrates, they can be life threatening.


Nowa Medycyna ◽  
2018 ◽  
Vol 25 (3) ◽  
Author(s):  
Zbigniew Tański ◽  
Zbigniew Jarząbek ◽  
Bartosz Konowalski ◽  
Maciej Truszkowski ◽  
Jakub Biedrzycki ◽  
...  

Introduction. Fournier’s gangrene is a necrotising soft-tissue infection characterized by insidious and rapid onset. It belongs to the group of necrotising soft-tissue infections. The disease is more common in patients with systemic predispositions such as diabetes mellitus, obesity, hepatic cirrhosis, cancer, etc. Aim. The results of medical treatment thirtieths patients (man from 34 to 84 years old, middle age 67 years old) and co-morbidity with Fournier’s gangrene was presented. Material and methods. The co-morbidity was discussed and analized. The patients were treated by antishock therapy, proper antibiotic therapy was applied. The complications were presented during treatment, procedures with wounds, debridement and wounds treatment and final treatment skin deficiency. All patients had covered skin deficiency by mesh grafts, they were discharged from hospital with healed wounds or almost healed. Treatment from medical literature dealing with treatment and experience of Urological Wards was also presented (Fournier’s gangrene is a part of this disease). Results. Mortality was not observed in this group of patients. Conclusions. Fournier’s gangrene is a rapid-onset, life-threatening, acute urological disease requiring immediate diagnosis, as well as anti-shock and antibacterial therapy combined with intensive surgical debridement followed by the management of skin and soft tissue defects.


2015 ◽  
Vol 11 (02) ◽  
pp. 83
Author(s):  
René Rodríguez-Gutiérrez ◽  
Gloria Gonzalez Saldivar ◽  
Jose Gerardo Gonzalez Gonzalez ◽  
Margo S Hudson ◽  
◽  
...  

Necrotizing fasciitis is one of the best-known soft tissue infections. Fournier’s gangrene is a type of necrotizing fasciitis of the genital, perianal, and perineal regions caused by the infection of multiple anerobic/aerobic microorganisms. We present the case of a 47-year-old man with a history of uncontrolled type 2 diabetes who presented to the emergency room with intense abdominal pain and signs of severe sepsis. A prompt diagnosis of a necrotizing fasciitis of the perineum (Fournier’s gangrene) was made and immediately broad-spectrum antibiotics, intravenous fluids, and surgical debridement were administered. The patient had an impressive response to treatment with resolution sepsis and was discharged 4 weeks after a skin graft of the abdominal and perineal areas. Fournier’s gangrene remains a life-threatening and many times fulminant disease in which a high grade of suspicion is needed for its diagnosis and rapid and assertive treatment for its survival.


2020 ◽  
Vol 7 (5) ◽  
pp. 1602
Author(s):  
Subhash Chandra Sharma ◽  
Vipin Kumar ◽  
Lalit Govind Vadher

Background: Fournier’s gangrene is life threatening, necrotizing fasciitis, affecting external genetalia of male greater than female with mortality 7 to 53%. Fournier gangrene severity, LRINR and LNR scoring used to evaluate morbidity and mortality. Aim and objective of our study was to simplify a system, especially for Indian peripheral health centers which can predict mortality, morbidity.Methods: This study was conducted in department of surgery of Teerthankar Mahaveer University. Body mass index, blood urea nitrogen and patient demography used to develop the scoring system with minimum and maximum points and correlated our results.Results: Our simplified scoring system also has a direct bearing on mortality, morbidity, recovery and hospital stay. In our study 3 male and 2 females died.Conclusions: Simplified scoring and grading system will be helpful in predicting the morbidity and mortality, early surgical intervention, hospital stay, time for reconstruction.


2016 ◽  
Vol 88 (3) ◽  
pp. 237 ◽  
Author(s):  
Remigio Pernetti ◽  
Fabiano Palmieri ◽  
Elisabetta Sagrini ◽  
Marco Negri ◽  
Claudio Morisi ◽  
...  

Fournier's gangrene is a life-threatening acute necrotizing fasciitis of perianal,genitourinary and perineal areas. Nowadays, is well known that Fournier gangrene is almost never an idiopathic disease. In this article we report a case of a 70-year-old patient that initially was not treated properly. The gold standard therapy of the Fournier's gangrene remains today a complete, early and extended surgical debridement.


2020 ◽  
Vol 63 (5) ◽  
pp. 26-30
Author(s):  
Paloma Pérez Ladrón de Guevara ◽  
Georgina Cornelio Rodríguez ◽  
Oscar Quiroz Castro

Fournier’s Gangrene is a type II necrotizing fascitis that leads to thrombosis of small subcutaneous vessels and spreads through the perianal and genital regions and the skin of the perineal. Most cases have a perianal or colorectal focus and in a smaller proportion it originates from the urogenital tract. The mortality rate varies between 7.8 and 50%1-3, only timely diagnosis decreases the morbidity and mortality of this condition. Treatment includes surgical debridement of all necrotic tissue and the use of broad-spectrum antibiotics. Key words: Fournier’s gangrene; gangrene; necrotizing fasciitis; infectious necrotizing of soft tissues.


Open Medicine ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. 1028-1037
Author(s):  
Domenico Tripodi ◽  
Maria Ida Amabile ◽  
Federica Gagliardi ◽  
Federico Frusone ◽  
Marzia Varanese ◽  
...  

Abstract Background Fournier’s gangrene is a rare form of necrotizing fasciitis that affects the genital area up to the perineal region and sometimes the abdominal wall. Objectives Our article aims to show that in the treatment of extensive forms of Fournier’s gangrene, correct use of flap and skin grafts and a quick reconstruction of the exposed tissues avoid scarring retraction of the testicles and deformation of the penis. Materials and methods We retrospectively reviewed the clinical and photographic data of Fournier’s gangrene cases treated at our Institute. The data were evaluated to obtain an estimate of the results of the reconstructive technique used, in terms of percentage of occurred healings and eventual complications. Results A total of 34 patients underwent surgery for Fournier’s gangrene. In nine cases (26.5%), we had minor complications: in four patients, suffering from diabetes and obesity, a retard in attachment of graft occurred, while in five patients with perianal problems there was a delay in healing due to the onset of local infection. Conclusion The reconstruction approach described here may reduce surgical times. In Fournier’s gangrene, the exposed tissues must be reconstructed as quickly as possible.


2015 ◽  
Vol 7 (3) ◽  
Author(s):  
Yael Kotton ◽  
Soboh Soboh ◽  
Naiel Bisharat

Necrotizing fasciitis is a severe life-threatening infection of the deep subcutaneous tissues and fascia. Infection with <em>Vibrio vulnificus</em>, a halophilic Gram-negative bacillus found worldwide in warm coastal waters, can lead to severe complications, particularly among patients with chronic liver diseases. We herein present an unusual case of necrotizing fasciitis caused by <em>V</em>. <em>vulnificus</em> triggered by acupuncture needle insertion. The patient, who suffered from diabetes mellitus and non-alcoholic fatty liver disease and worked at a fish hatchery, denied any injury prior to acupuncture. This is the first ever reported case of <em>V. vulnificus</em> infection triggered by acupuncture needle insertion, clearly emphasizing the potential hazards of the prolonged survival of <em>V. vulnificus</em> on the skin. The potential infectious complications of acupuncture needle insertion are discussed.


2015 ◽  
Vol 47 (5) ◽  
pp. 271-273 ◽  
Author(s):  
E. Sebastian-Valverde ◽  
C. Pañella-Vilamú ◽  
E. Membrilla-Fernández ◽  
J. J. Sancho-Insenser ◽  
L. Grande-Posa

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