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Fournier's Gangrene - A Case Report with a Review of the Literature

Received: 14 August 2023     Accepted: 4 September 2023     Published: 13 September 2023
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Abstract

Fournier's gangrene is a rare form of necrotizing fasciitis, also known as "flesh-eating disease." It cause extensive necrosis of skin, fascia, and subcutaneous of the external genitalia, perineal and perianal areas. The etiology is usually polymicrobial. Initial dermatological symptoms may be missing or mimicking erysipelas, cellulite or abscess. The disease is life-threatening with fulminant onset and prominent intoxication symptoms. Early diagnosis, complex treatment and urgent surgical debridement are crucial in reducing lethal outcome. We describe a case of a 38-year-old man with fever, erythema, edema and severe pain in his testicles and perineum 4 days before hospitalization. He was with poor general condition. The patient had a history of recent Covid-19 infection that worsened his metabolic syndrome and chronic pulmonary obstructive disease. Blood tests showed leukocytosis and extremely elevated C-reactive protein, and microbiological plating - beta streptococci and Staphylococcus aureus. Broad-spectrum antibiotics, aggressive debridement, adequate resuscitation and local treatment of the wound provided fast recovery and favourable outcome. An overview of the epidemiology, risk factors, etiological microorganisms, clinical picture, systemic and local complications, psychological problems, laboratory and imaging diagnostic methods of Fournier's gangrene is presented. Fournier’s gangrene and necrotizing fasciitis clinical risk assessment systems are also highlighted. Most appropriate therapeutic modalities are comprehensively discussed.

Published in International Journal of Clinical Dermatology (Volume 6, Issue 2)
DOI 10.11648/j.ijcd.20230602.12
Page(s) 18-23
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2023. Published by Science Publishing Group

Keywords

Fournier’s Gangrene, Life-Threatening Condition, Fasciotomy

References
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Cite This Article
  • APA Style

    Hristo Mangarov, Valentina Broshtilova, Atanas Batashki, Svetlana Bezhanova, Yoanna Velevska, et al. (2023). Fournier's Gangrene - A Case Report with a Review of the Literature. International Journal of Clinical Dermatology, 6(2), 18-23. https://doi.org/10.11648/j.ijcd.20230602.12

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    ACS Style

    Hristo Mangarov; Valentina Broshtilova; Atanas Batashki; Svetlana Bezhanova; Yoanna Velevska, et al. Fournier's Gangrene - A Case Report with a Review of the Literature. Int. J. Clin. Dermatol. 2023, 6(2), 18-23. doi: 10.11648/j.ijcd.20230602.12

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    AMA Style

    Hristo Mangarov, Valentina Broshtilova, Atanas Batashki, Svetlana Bezhanova, Yoanna Velevska, et al. Fournier's Gangrene - A Case Report with a Review of the Literature. Int J Clin Dermatol. 2023;6(2):18-23. doi: 10.11648/j.ijcd.20230602.12

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  • @article{10.11648/j.ijcd.20230602.12,
      author = {Hristo Mangarov and Valentina Broshtilova and Atanas Batashki and Svetlana Bezhanova and Yoanna Velevska and Petar Vatov and Irina Yungareva and Sonya Marina},
      title = {Fournier's Gangrene - A Case Report with a Review of the Literature},
      journal = {International Journal of Clinical Dermatology},
      volume = {6},
      number = {2},
      pages = {18-23},
      doi = {10.11648/j.ijcd.20230602.12},
      url = {https://doi.org/10.11648/j.ijcd.20230602.12},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcd.20230602.12},
      abstract = {Fournier's gangrene is a rare form of necrotizing fasciitis, also known as "flesh-eating disease." It cause extensive necrosis of skin, fascia, and subcutaneous of the external genitalia, perineal and perianal areas. The etiology is usually polymicrobial. Initial dermatological symptoms may be missing or mimicking erysipelas, cellulite or abscess. The disease is life-threatening with fulminant onset and prominent intoxication symptoms. Early diagnosis, complex treatment and urgent surgical debridement are crucial in reducing lethal outcome. We describe a case of a 38-year-old man with fever, erythema, edema and severe pain in his testicles and perineum 4 days before hospitalization. He was with poor general condition. The patient had a history of recent Covid-19 infection that worsened his metabolic syndrome and chronic pulmonary obstructive disease. Blood tests showed leukocytosis and extremely elevated C-reactive protein, and microbiological plating - beta streptococci and Staphylococcus aureus. Broad-spectrum antibiotics, aggressive debridement, adequate resuscitation and local treatment of the wound provided fast recovery and favourable outcome. An overview of the epidemiology, risk factors, etiological microorganisms, clinical picture, systemic and local complications, psychological problems, laboratory and imaging diagnostic methods of Fournier's gangrene is presented. Fournier’s gangrene and necrotizing fasciitis clinical risk assessment systems are also highlighted. Most appropriate therapeutic modalities are comprehensively discussed.},
     year = {2023}
    }
    

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  • TY  - JOUR
    T1  - Fournier's Gangrene - A Case Report with a Review of the Literature
    AU  - Hristo Mangarov
    AU  - Valentina Broshtilova
    AU  - Atanas Batashki
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    AU  - Yoanna Velevska
    AU  - Petar Vatov
    AU  - Irina Yungareva
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    T2  - International Journal of Clinical Dermatology
    JF  - International Journal of Clinical Dermatology
    JO  - International Journal of Clinical Dermatology
    SP  - 18
    EP  - 23
    PB  - Science Publishing Group
    SN  - 2995-1305
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    AB  - Fournier's gangrene is a rare form of necrotizing fasciitis, also known as "flesh-eating disease." It cause extensive necrosis of skin, fascia, and subcutaneous of the external genitalia, perineal and perianal areas. The etiology is usually polymicrobial. Initial dermatological symptoms may be missing or mimicking erysipelas, cellulite or abscess. The disease is life-threatening with fulminant onset and prominent intoxication symptoms. Early diagnosis, complex treatment and urgent surgical debridement are crucial in reducing lethal outcome. We describe a case of a 38-year-old man with fever, erythema, edema and severe pain in his testicles and perineum 4 days before hospitalization. He was with poor general condition. The patient had a history of recent Covid-19 infection that worsened his metabolic syndrome and chronic pulmonary obstructive disease. Blood tests showed leukocytosis and extremely elevated C-reactive protein, and microbiological plating - beta streptococci and Staphylococcus aureus. Broad-spectrum antibiotics, aggressive debridement, adequate resuscitation and local treatment of the wound provided fast recovery and favourable outcome. An overview of the epidemiology, risk factors, etiological microorganisms, clinical picture, systemic and local complications, psychological problems, laboratory and imaging diagnostic methods of Fournier's gangrene is presented. Fournier’s gangrene and necrotizing fasciitis clinical risk assessment systems are also highlighted. Most appropriate therapeutic modalities are comprehensively discussed.
    VL  - 6
    IS  - 2
    ER  - 

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Author Information
  • Department of Dermatology and Venereology, Medical Institute of the Ministry of Internal Affairs, Sofia, Bulgaria

  • Department of Dermatology and Venereology, Eurohealth Clinic, Sofia, Bulgaria

  • Department of Special Surgery, Medical University, Plovdiv, Bulgaria

  • Department of Gastroenterology, Medical Institute of the Ministry of Internal Affairs, Sofia, Bulgaria

  • Department of Infectious Diseases, Parasitology and Dermatovenereology, Medical University, Varna, Bulgaria

  • Department of Surgical Diseases, Unit of Urology, Medical University, Varna, Bulgaria

  • Department of Dermatology and Venereology, Medical Institute of the Ministry of Internal Affairs, Sofia, Bulgaria

  • Department of Dermatology and Venereology, Medical Institute of the Ministry of Internal Affairs, Sofia, Bulgaria

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