Clinical case of Fournier’s gangrene in a patient with adenocarcinoma

The article describes a clinical case of Fournier’s gangrene in a 65-year-old man with rectal mucinous adenocarcinoma. Given the presence of a malignant neoplasm, elderly age and the general severity of the patient’s condition, the widest empirical antibiotic therapy was prescribed, the spectrum of which overlapped the most probable pathogens. The patient was discharged from the hospital on the 32nd day. The article discusses the rational tactics of antimicrobial therapy in such difficult cases for treatment.

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Fournier’s gangrene following an ant bite in a healthy man: A very rare case report

Journal of Emergency Practice and Trauma ◽

10.34172/jept.2020.02 ◽

2020 ◽

Vol 6 (2) ◽

pp. 115-117

Author(s):

Abbas Edalatkhah ◽

Mohammad Ali Jafari ◽

Sima Valizadeh ◽

Alireza Esmaeili ◽

Ehsan Zarepur

Keyword(s):

Case Report ◽

Physical Examination ◽

Antibiotic Therapy ◽

Rare Case ◽

Saline Solution ◽

Fournier’S Gangrene ◽

Fournier's Gangrene ◽

Case Presentation ◽

Rare Case Report ◽

Extensive Necrosis

Objective: Necrotizing fasciitis of the perinea, referred to as Fournier’s gangrene, is a necrotizing infection of the perinea. To the best of our knowledge, there is no report on the Fournier’s gangrene following an ant bite and this is a rare case report of this type. Case Presentation: In this rare case report we describe a 20-year-old man who developed Fournier’s gangrene following an ant bite which resulted in his death. He sustained numerous ant bites in the perinea. Subsequently, he suffered from itching of the area and had scratched the area frequently leading to dermal ulcers and laceration, pain, and swelling of the scrotal area followed by fever and diminished consciousness. Finally, he presented to the emergency room (ER) after 72 hours of ant bites with a shock. Physical examination revealed extensive necrosis of scrotum. The primary treatments including antibiotic therapy, normal saline solution, and dopamine were not effective. Conclusion: Even a simple nonpoisonous insect bite can lead to Fournier’s gangrene and death. Paying greater attention to the site of bite, especially in the perinea which is anatomically more susceptible to infection, observing hygienic principles, and quick access to healthcare centers may prevent the patient’s death.

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A conservative approach to perineal Fournier's gangrene

Archivio Italiano di Urologia e Andrologia ◽

10.4081/aiua.2015.1.28 ◽

2015 ◽

Vol 87 (1) ◽

pp. 28 ◽

Cited By ~ 4

Author(s):

Giulio Milanese ◽

Luigi Quaresima ◽

Marco Dellabella ◽

Alessandro Scalise ◽

Giovanni Maria Di Benedetto ◽

...

Keyword(s):

Antibiotic Therapy ◽

Hyperbaric Oxygen ◽

Reconstructive Surgery ◽

Hyperbaric Oxygen Therapy ◽

Oxygen Therapy ◽

Multidisciplinary Approach ◽

Complete Healing ◽

Fournier’S Gangrene ◽

Enhancement Effect ◽

Fournier's Gangrene

Fournier’s gangrene (FG) is a disease involving necrosis of perineum and external genitalia; in 95% of cases it is possible to diagnose the Fournier’s gangrene just by physical examination. The clinical presentation of FG varies from an initial localized infection to large areas with necrotizing infection. The disease typically affect elderly men (6°-7° decade) with important systemic comorbidities; women are less frequently affected. Despite improvements in diagnosis and management, the mortality rate nowadays is between 20% and 43%. The severity and mortality of the disease is dependent upon the general condition of the patient at presentation and upon the rate of spread of the infection. Treatment involves a multidisciplinary approach: intensive systematic management, broad-spectrum antibiotic therapy, early surgical debridement (wide abscission of necrotic tissues and surgical drainage of peritoneum, scrotum, penis, and inguinal areas), hyperbaric oxygen therapy; surgery can eventually be repeated if necessary; reconstructive surgery has an important role in the final treatment of the disease. The technical difficulties frequently encountered and the inability to make a complete removal of the necrotizing tissues at the time of surgery in some cases has led to the application of combined techniques, in view of the enhancement effect of specific advanced medications, targeted antibiotic therapy and hyperbaric medicine. We have considered 6 patients affected by Fournier’s gangrene treated at our institution; all the patients received treatment with the help of plastic surgeons of the same institution. After debridement, all the patients were treated with advanced specific dressings consisting of plates and strips made of calcium alginate, hydrogels and polyurethane and twodimensional cavity foams. Reconstructive surgery was necessary in one case. Hyperbaric oxygen therapy (HBO) has been performed in all cases. The multidisciplinary approach, the combined use of HBO therapy and the adoption of advanced specific dressings, have made possible the complete healing of the lesions in a shorter period, avoiding further surgery in 5 out of 6 patients.

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Shewanella-Related Bacteremia and Fournier's Gangrene: A Case Report

Open Forum Infectious Diseases ◽

10.1093/ofid/ofw148 ◽

2016 ◽

Vol 3 (3) ◽

Cited By ~ 3

Author(s):

Tommy Hing-cheung Tang ◽

Naomi Hua-yin Cheng ◽

Roy Tsz-chung Ho ◽

Helen Shuk-ying Chan ◽

Kwok-wai Lam ◽

...

Keyword(s):

Nephrotic Syndrome ◽

Case Report ◽

Antibiotic Therapy ◽

Fournier’S Gangrene ◽

Surgical Debridement ◽

Fournier's Gangrene ◽

First Case ◽

Shewanella Algae ◽

Serious Infections ◽

Chinese Male

AbstractShewanella algae and Shewanella putrefaciens have been implicated for causing serious infections in humans, including disseminated infection. We report the possible first case of Shewanella-related Fournier's gangrene and bacteremia caused in a 65-year-old Chinese male with nephrotic syndrome. He was successfully managed by surgical debridement and antibiotic therapy.

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A clinical case of Fournier’s gangrene: imaging ultrasound

Journal of Ultrasound ◽

10.1007/s40477-014-0106-5 ◽

2014 ◽

Vol 17 (4) ◽

pp. 303-306 ◽

Cited By ~ 5

Author(s):

Marco Di Serafino ◽

Chiara Gullotto ◽

Chiara Gregorini ◽

Claudia Nocentini

Keyword(s):

Clinical Case ◽

Fournier’S Gangrene ◽

Fournier's Gangrene

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Fournier's gangrene: Clinical case and review of the literature

Archivio Italiano di Urologia e Andrologia ◽

10.4081/aiua.2016.3.237 ◽

2016 ◽

Vol 88 (3) ◽

pp. 237 ◽

Cited By ~ 5

Author(s):

Remigio Pernetti ◽

Fabiano Palmieri ◽

Elisabetta Sagrini ◽

Marco Negri ◽

Claudio Morisi ◽

...

Keyword(s):

Gold Standard ◽

Standard Therapy ◽

Clinical Case ◽

Fournier’S Gangrene ◽

Review Of The Literature ◽

Fournier's Gangrene ◽

Fournier Gangrene ◽

Acute Necrotizing ◽

Life Threatening ◽

Idiopathic Disease

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.

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532: Empirical Antibiotic Therapy in the Management of Elevated Serum PSA- A Viable Option?

The Journal of Urology ◽

10.1016/s0022-5347(18)32778-2 ◽

2006 ◽

Vol 175 (4S) ◽

pp. 172-172

Author(s):

Chee Kwan Ng ◽

Gerald Y. Tan ◽

Khai Lee Toh ◽

Sing Joo Chia ◽

James K. Tan

Keyword(s):

Antibiotic Therapy ◽

Elevated Serum ◽

Empirical Antibiotic Therapy ◽

Viable Option

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Fournier's gangrene as Amyand's hernia complication

Perspectives in Surgery ◽

10.33699/pis.2019.98.7.291-296 ◽

2019 ◽

Vol 98 (7) ◽

pp. 291-296

Keyword(s):

Case Report ◽

Case Reports ◽

Rare Condition ◽

Sporadic Case ◽

Fournier’S Gangrene ◽

Amyand’S Hernia ◽

Fournier's Gangrene ◽

Randomized Controlled Studies ◽

Based Medicine ◽

Hernia Complication

Introduction: Fournier’s gangrene is a rare but fast deteriorating and serious condition with high mortality. In most cases, it is characterized as necrotizing fasciitis of the perineum and external genitals. Amyand’s hernia is a rare condition where the appendix is contained in the sac of an inguinal hernia. Inflammatory alterations in the appendix account only for 0.1 % of the cases when Amyand’s hernia is verified. Fournier’s gangrene as a complication of a late diagnosis of appendicitis located in the inguinal canal is described in the literature as rare case reports. Case report: The case report of a 70-year-old patient with Fournier’s gangrene resulting from gangrenous appendicitis of Amyand’s hernia. Conclusion: Fournier’s gangrene as a complication of Amyand’s hernia is a rare condition. Only sporadic case reports thereof can be found in the literature. Because of the rarity of this pathology and the lack of randomized controlled studies, it is difficult to determine the optimal treatment according to the principles of evidence-based medicine. An appropriate approach for this condition appears to be the combination of guidelines developed in Amyand’s therapy according to Losanoff and Basson, along with the recommended “gold standard” therapy for Fournier’s gangrene. This means early and highly radical surgical debridement, adequate antibiotic therapy and intensive care.

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Fournier’s gangrene due to Salmonella Typhimurium in a healthy male: a rare aberrant infection

Infectious Disorders - Drug Targets ◽

10.2174/1871526520666201117143421 ◽

2020 ◽

Vol 20 ◽

Author(s):

Varsha Gupta ◽

Lipika Singhal ◽

Kritika Pal ◽

Mani Bhushan ◽

Rajeev Sharma ◽

...

Keyword(s):

Salmonella Typhimurium ◽

Systemic Disease ◽

External Genitalia ◽

Fournier’S Gangrene ◽

The Body ◽

Healthy Male ◽

Fournier's Gangrene ◽

Salmonella Infections ◽

Chief Complaints ◽

Human Infections

Introduction: Human Salmonella infections have been classically distinguised into diseases caused by typhoidal and non-typhoidal salmonella (NTS). Typhiodal salmonella includes S. enterica serovars Typhi and Paratyphi that cause the systemic disease but are restricted to human infections, while NTS consists mainly of other serovars that predominantly cause self-limiting gastroenteritis in humans. Localisation of foci with persisting infection occurs due to dissemination of the bacteria throughout the body and can cause a variety of rare clinical syndromes at aberrant sites. Fournier’s gangrene, a rapidly progressive, often fatal, necrotizing fasciitis of the external genitalia and perineum due to Salmonella Typhimurium, is a rare manifestation and has never been reported. Case: A 22-year-old male, apparently healthy patient with no relevant past medical history presented to surgical emergency with chief complaints of swelling of bilateral scrotal area. Infective etiology was considered and a diagnosis of fournier’s gangrene was made. Pure growth of Salmonella Typhimurium was obtained after repeated subculture and was identified biochemically and on serotyping, as Salmonella enterica serotype Typhimurium using specific antisera. Conclusion: In our case report, we describe a case of fournier’s gangrene due to Salmonella Typhimurium in an otherwise healthy male to highlight the unusual presentation of Non typhoidal salmonellae at an aberrant site. We also emphasize the importance of using selective media like Selenite F broth for isolation of Salmonella Typhimurium from a pus sample.

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Gangrena de Fournier. Reporte de caso

Studies in the Economic History of Southern Africa ◽

10.22201/fm.24484865e.2020.63.5.04 ◽

2020 ◽

Vol 63 (5) ◽

pp. 26-30

Author(s):

Paloma Pérez Ladrón de Guevara ◽

Georgina Cornelio Rodríguez ◽

Oscar Quiroz Castro

Keyword(s):

Mortality Rate ◽

Necrotizing Fasciitis ◽

Broad Spectrum ◽

Soft Tissues ◽

Fournier’S Gangrene ◽

Type Ii ◽

Necrotic Tissue ◽

Fournier's Gangrene ◽

Necrotizing Fascitis ◽

Key Words Fournier's Gangrene

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.

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Colour Me Blue: The History and the Biotechnological Potential of Pyocyanin

Molecules ◽

10.3390/molecules26040927 ◽

2021 ◽

Vol 26 (4) ◽

pp. 927

Author(s):

Thiago Gonçalves ◽

Ulrich Vasconcelos

Keyword(s):

Pseudomonas Aeruginosa ◽

Antibiotic Therapy ◽

Electric Current ◽

Antimicrobial Therapy ◽

Blue Colour ◽

Current Generation ◽

Biotechnological Potential ◽

Avant Garde ◽

New Horizons ◽

The Subject

Pyocyanin was the first natural phenazine described. The molecule is synthesized by about 95% of the strains of Pseudomonas aeruginosa. From discovery up to now, pyocyanin has been characterised by a very rich and avant-garde history, which includes its use in antimicrobial therapy, even before the discovery of penicillin opened the era of antibiotic therapy, as well as its use in electric current generation. Exhibiting an exuberant blue colour and being easy to obtain, this pigment is the subject of the present review, aiming to narrate its history as well as to unveil its mechanisms and suggest new horizons for applications in different areas of engineering, biology and biotechnology.

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