Fournier坏疽五例诊治分析

目的:探讨Fournier坏疽的临床特点,提高该病诊疗水平.方法:回顾性分析5例Fournier坏疽临床资料并复习相关文献.结果:本组5例Fournier坏疽中,阴囊坏疽4例,阴茎皮肤坏疽1例,均伴随高热、寒战、局部皮肤肿胀、溃烂及坏死,行坏死组织渗液细菌培养有大肠杆菌生长3例(其中1例同时有溶血性链球菌生长),金黄色葡萄球菌生长2例(其中1例同时有产气荚膜杆菌生长).5例经清创引流、抗感染及对症治疗等,3例康复,2例死亡.结论:早期切开引流,广泛清创,快速纠正休克,及时使用广谱抗生素,以及全身支持疗法和必要的重复清创,是Fournier坏疽治疗成功的关键.     

广泛耐药致病菌感染引发Fournier坏疽2例报告并文献复习

目的:探讨Fournier坏疽早期诊断及有效治疗的办法。方法回顾性分析江西省人民医院2015年收治的2例Fournier坏疽患者的临床资料。结果 2例Fournier坏疽患者虽经早期诊断、积极清创引流及抗感染对症支持治疗,终因感染性休克死亡。结论 Fournier坏疽发病凶险病死率高,早期诊断十分重要,彻底的清创引流等对预后有重要的作用。     

Fournier坏疽18例诊治体会

目的:探讨Fournier坏疽的临床表现及诊疗。方法:回顾性分析我院收治的18例男性Fournier综合征患者的临床资料及治疗情况。患者年龄24～84岁,平均53.6岁。其中肛周间隙坏死12例,阴囊坏疽13例,阴茎皮肤坏疽1例。细菌培养16例,阳性10例。均行外科清创、引流、抗感染等治疗,8例行高压氧治疗。结果:13例经二期缝合痊愈出院,其中3例1个月后行皮瓣成形术。死亡5例,均为并发败血症、早期出现肾功能受损而致多器官功能衰竭死亡。结论:Fournier坏疽是肛周、外生殖器及会阴部的严重的坏死性筋膜炎,早诊断早期广泛清创治疗是关键,治疗以早期广泛清创及应用广谱抗生素为主,加强局部引流。早期出现感染性休克是可能预后不良的征兆。     

Fournier坏疽3例

正Fournier坏疽(Fournier's gangrene)是发生于外生殖器和/或会阴的一种进展性坏死性软组织感染。该病是一种少见的泌尿外科急症,早期诊断和及时治疗可为患者挽救治疗时间,但即便早期广谱抗生素治疗和外科清创,仍可能死亡。2016年我院收治3例Fournier坏疽患者,经积极治疗后均顺利出院,现结合临床资料和复习相关文献,     

糖尿病继发Fournier坏疽6例诊治分析

目的:总结糖尿病继发Fournier坏疽的诊断及治疗经验.方法:回顾性分析6例糖尿病继发Fournier坏疽患者主要症状及诊治情况,结合文献对该病的临床表现、诊断、治疗及预后进行讨论.结果:6例患者均行外科清创、引流、抗感染等综合治疗,5例患者经二期缝合痊愈出院;1例高龄患者早期出现感染性休克及多器官功能衰竭而死亡.结论:早期诊断,及时彻底局部综合治疗,早期联合应用广谱抗生素及控制血糖等全身治疗,是治愈本病的关键.     

肛周部急性坏死性筋膜炎患者的护理

肛周会阴部急性坏死性筋膜炎首先由Fournier在1883年报道,亦称Fournier′s综合征,Meleney于1924年报道了链球菌性坏疽,1952年Wilson将皮肤、皮下组织、浅深筋膜的进行性坏死称为急性坏死性筋膜炎〔1〕。是由多种细菌感染引起的肛门周围软组织、     

Fournier坏疽患者的护理

Fournier坏疽又称爆发性阴囊坏疽,它是一种少见、凶险的阴囊感染坏死性筋膜炎[1],常累及阴茎、肛周、腹股沟及腹部皮下多部位.其起病急、进展快、死亡率高[2].1996年5月～2007年12月.我院收治Fournier坏疽患者6例,治疗效果良好,报告如下.     

手术治疗和中医保守治疗Fournier坏疽的对比分析

目的为了观察手术治疗和中医保守治疗Fournier坏疽的临床疗效。方法将外院中医保守治疗未愈转入我院的10例患者分为A组，将我院Fournier坏疽中随机抽取的30位患者分为B组，对比分析治疗结果。结果A组中医保守治疗组全部未愈，B组手术治疗组除1例死亡外全部治愈。结论Foumier坏疽宜选用手术治疗加术后化腐生肌治疗。     

肛周坏死性筋膜炎7例临床分析

<正>肛周坏死性筋膜炎(perianal necrotizing fasciitis,PNF)又称为Fournier’s坏疽、会阴部产气性皮下蜂窝织炎。是一种发生于肛周、会阴部的严重软组织感染性疾病,伴有多种细菌感染,造成皮肤及皮下组织化脓性坏死,并可经会阴浅筋膜蔓延至腹壁(下肢)。该病起病急骤,发展迅速凶险,如延误治疗,毒素可经     

1例特发性阴囊坏疽病人围手术期护理

特发性阴囊坏疽又称Fournier坏疽,本病发病急,起病快,发展迅速,治疗困难。我院2011年12月4日收治1例特发性阴囊坏疽病人,经积极治疗与精心护理,治愈出院。现报道如下。     

Fournier’s gangrene: Is it scrotal gangrene?

INTRODUCTION: Fournier's gangrene was originally described as scrotal gangrene in young males. Today, it is generally accepted as synergistic necrotizing fasciitis of perineal, genital, or perianal regions, and the epidemiologic data have changed. However, there are still limited data about females due to the lack of female patients, even in large case series. METHODS: A retrospective review of the medical records of all patients who received surgery for emergency conditions over the past 22 years was performed to identify patients with Fournier's gangrene. Data from these patients were then reviewed to determine the age, gender, etiology, causative bacteria, predisposing factors, treatment modalities, length of hospital stay, and morbidity and mortality rates associated with Fournier's gangrene. Data were evaluated using multivariate analyses. RESULTS: Sixty-five patients (20 female) were identified with the diagnosis of Fournier's gangrene. The mean age was 50.8 years. The most common etiology was hemorrhoidectomy in male and perianal abscess in female patients. The most commonly isolated microorganism in both male and female patients was Escherichia coli. Twenty-nine patients had diabetes mellitus, which was the most common predisposing factor. Mean hospitalization time was 24.4 days and the overall mortality was 27.70%. CONCLUSION: Fournier's gangrene is still an important disease with high mortality rates in spite of the developments in intensive care units and new-generation antibiotics. It seems that there are no major differences between male and female patients in the characteristics of the condition.     

Treatment of Fournier's gangrene with adjunctive hyperbaric oxygen therapy

Fournier's gangrene is a devastating infection and often is associated with a high morbidity and mortality. Surgical debridement and antibiotics are the cornerstones of therapy. This case describes the use of hyperbaric oxygen as an adjunct in the treatment of Fournier's gangrene.     

Fournier's syndrome in a ketoacidotic diabetic patient after intrascrotal insulin injections because of impotence

Fournier's syndrome is a necrotizing fasciitis most commonly confined to the male genitalia with high morbidity and mortality rates. The salient features are (1) sudden explosive illness in the midst of apparent health; (2) rapid necrosis and sloughing of tissues of the scrotum and penis; (3) absence of an obvious cause; (4) a mixed bacteriologic picture; and (5) gangrene affecting the whole thickness of the scrotal skin, but not the underlying testes. With the propensity toward life-threatening infections in patients with diabetes, it is surprising that Fournier's syndrome is not more common in suboptimally treated diabetic patients. This report is to illustrate the recognition and treatment of Fournier's syndrome in a patient with diabetes. Also, it must be emphasized that the explosive course of the disease process begins with a benign-appearing, epididymitis-like picture. Prompt recognition followed by prompt surgical debridement and appropriate antibiotic therapy along with surgical wound closure is necessary to reduce morbidity and mortality. The present case is unusual for the following reasons: (1) necrosis of the testicles requiring orchiectomy; (2) extensive spread of gangrene beyond the genitalia; and (3) the route of infection, which appeared to be intrascrotal injections of insulin in a vain attempt to cure impotence.     

Fournier's disease: Necrotizing gangrene of the male genitalia

Fournier's disease, a necrotizing subcutaneous infection involving the male genitalia, was first described by the French venereologist Jean Alfred Fournier in 1884. Its characteristic triad of abrupt onset in young, previously healthy males, rapid progression to gangrene, and absence of a discernable cause appear to have been altered, at least partially, by the advent of the antibiotic era. We present a case report, with discussion of the clinical and pathophysiological mechanisms involved in this rare and malignant infectious process.     

FOURNIER'S GANGRENE

SUMMARY Fournier's gangrene was traditionally thought to arise spontaneously. More recently, cases with urological, perianal or systemic predisposing causes have been reported. This report describes four cases of Fournier's gangrene, all associated with a predisposing cause: two with diabetes mellitus, two secondary to urinary tract pathologies, and one secondary to an infected wound after an inguinal herniorrhaphy.     

Emergent surgical complications of genitourinary infections

The entities described in this article represent processes that arise from, or can be mistaken for, common GU infections. It might be difficult to determine the point at which pyelonephritis develops into EPN or perinephric abscess. It might be equally challenging to distinguish scrotal cellulitis from Fournier's gangrene; however, as most EPs will acknowledge, the mere awareness of these entities in the appropriate clinical circumstances might be enough to prevent a "near-miss" of a surgical emergency.     

Emergency diagnosis of Fournier's gangrene with bedside ultrasound

Fournier gangrene is a life-threatening infection of the scrotal skin. Although originally thought to be an idiopathic process, Fournier gangrene has been shown to have a predilection for patients with diabetes as well as chronic alcohol abuse; however, it can also affect patients with nonobvious immune compromise. Because of potential complications, it is important to diagnose the disease process as early as possible. Ultrasound has been previously described to aid in the diagnosis of Fournier's gangrene. In patients with low to moderate suspicion of Fournier gangrene, it may provide a rapid and reliable diagnosis and differentiate the pathological process from mimicking entities such as scrotal edema or cellulitis. We present 6 cases of Fournier's gangrene diagnosed in the ED at the patient's bedside using ultrasound. None of the patients had a history of diabetes, and 5 had sources of infection determined.     

Evaluation of male external genital diseases in the emergency room setting

This article briefly discusses various diseases of the external genitalia as they pertain to the emergency physician. Conditions emphasized include penile and scrotal trauma, Fournier's gangrene, and the "acute" scrotum. Practical advice regarding diagnosis and treatment is offered.     

Hyperbaric oxygen therapy for Fournier's gangrene

Soft-tissue infections with tissue necrosis, due to mixed aerobic and anaerobic organisms, are an accepted indication for hyperbaric oxygen (HBO) therapy. A unique type of such infection is Fournier's gangrene. This condition represents a serious risk to life and patients should be treated rapidly and aggressively. We treated three such cases by HBO. All three patients recovered from the infection, although one died later from renal and pulmonary complications.     

Fournier's gangrene: CT findings

Fournier's gangrene is an uncommon gasforming infection of the scrotum which if not recognized early and treated appropriately may be fatal. In three patients recently seen at our institution, computed tomography (CT) was instrumental in establishing the correct diagnosis and determining the extent of the infectious process prior to surgery. The imaging findings at CT and its differential diagnosis are illustrated. A brief review of the current theories of pathogenesis of this interesting entity is presented.