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Successful treatment following early recognition of a case of Fournier's scrotal gangrene after a perianal abscess debridement: a case report.
J Med Case Rep. 2018 Jun 27; 12(1):193.JM

Abstract

BACKGROUND

Fournier's gangrene is an acute surgical emergency characterized by high mortality rates ranging from approximately 13% to 45%. Therefore, aggressive multidisciplinary management is necessary.

CASE PRESENTATION

A 29-year-old Asian man who had undergone surgical debridement at another hospital to treat a perianal abscess 5 days earlier was admitted to our hospital for severe scrotal and perianal pain, swelling, and high fever. A physical examination revealed a perianal abscess. Furthermore, the scrotum was gangrenous and exhibited extensive cellulitis in the perineum and bilateral inguinal area. Crepitations between the skin and fascia were palpable. A diagnosis of Fournier's gangrene was made. The patient was treated with immediate surgical debridement under general anesthesia. He received broad-spectrum antibiotics, and debridement was repeated until the wound exhibited healthy granulation. Because both testes were severely exposed, they were transpositioned back into the scrotum 1 week after surgery. The patient was discharged on the 11th postoperative day.

CONCLUSIONS

The mainstay of treatment for Fournier's gangrene should include fluid resuscitation, broad-spectrum antibiotic therapy, intensive care, nutritional support, and early aggressive surgical debridement of all necrotic tissue.

Links

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Authors+Show Affiliations

Chen Y
Department of Urological Surgery, Chang Gung Memorial Hospital, 123 Avenue Xiafei, Xiamen, 361028, Fujian, China. 15928150413@163.com.
Wang X
Department of Urological Surgery, Chang Gung Memorial Hospital, 123 Avenue Xiafei, Xiamen, 361028, Fujian, China.
Lin G
Department of Urological Surgery, Chang Gung Memorial Hospital, No. 5 Fuxing Street, Guishan District, Taoyuan, Taiwan.
Xiao R
Department of Urological Surgery, Chang Gung Memorial Hospital, 123 Avenue Xiafei, Xiamen, 361028, Fujian, China.

MeSH

AbscessAdultDebridementFournier GangreneHumansMaleScrotum

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

29945675

Citation

Chen, Youwen, et al. "Successful Treatment Following Early Recognition of a Case of Fournier's Scrotal Gangrene After a Perianal Abscess Debridement: a Case Report." Journal of Medical Case Reports, vol. 12, no. 1, 2018, p. 193.
Chen Y, Wang X, Lin G, et al. Successful treatment following early recognition of a case of Fournier's scrotal gangrene after a perianal abscess debridement: a case report. J Med Case Rep. 2018;12(1):193.
Chen, Y., Wang, X., Lin, G., & Xiao, R. (2018). Successful treatment following early recognition of a case of Fournier's scrotal gangrene after a perianal abscess debridement: a case report. Journal of Medical Case Reports, 12(1), 193. https://doi.org/10.1186/s13256-018-1697-9
Chen Y, et al. Successful Treatment Following Early Recognition of a Case of Fournier's Scrotal Gangrene After a Perianal Abscess Debridement: a Case Report. J Med Case Rep. 2018 Jun 27;12(1):193. PubMed PMID: 29945675.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Successful treatment following early recognition of a case of Fournier's scrotal gangrene after a perianal abscess debridement: a case report. AU - Chen,Youwen, AU - Wang,Xueke, AU - Lin,Guoren, AU - Xiao,Rukai, Y1 - 2018/06/27/ PY - 2017/09/15/received PY - 2018/01/31/accepted PY - 2018/6/28/entrez PY - 2018/6/28/pubmed PY - 2019/5/9/medline KW - Fournier’s gangrene KW - Necrotizing fasciitis KW - Perianal abscess debridement KW - Streptococcus agalactiae SP - 193 EP - 193 JF - Journal of medical case reports JO - J Med Case Rep VL - 12 IS - 1 N2 - BACKGROUND: Fournier's gangrene is an acute surgical emergency characterized by high mortality rates ranging from approximately 13% to 45%. Therefore, aggressive multidisciplinary management is necessary. CASE PRESENTATION: A 29-year-old Asian man who had undergone surgical debridement at another hospital to treat a perianal abscess 5 days earlier was admitted to our hospital for severe scrotal and perianal pain, swelling, and high fever. A physical examination revealed a perianal abscess. Furthermore, the scrotum was gangrenous and exhibited extensive cellulitis in the perineum and bilateral inguinal area. Crepitations between the skin and fascia were palpable. A diagnosis of Fournier's gangrene was made. The patient was treated with immediate surgical debridement under general anesthesia. He received broad-spectrum antibiotics, and debridement was repeated until the wound exhibited healthy granulation. Because both testes were severely exposed, they were transpositioned back into the scrotum 1 week after surgery. The patient was discharged on the 11th postoperative day. CONCLUSIONS: The mainstay of treatment for Fournier's gangrene should include fluid resuscitation, broad-spectrum antibiotic therapy, intensive care, nutritional support, and early aggressive surgical debridement of all necrotic tissue. SN - 1752-1947 UR - https://www.unboundmedicine.com/medline/citation/29945675/Successful_treatment_following_early_recognition_of_a_case_of_Fournier's_scrotal_gangrene_after_a_perianal_abscess_debridement:_a_case_report_ DB - PRIME DP - Unbound Medicine ER -