Abstract
Perineal necrotizing fasciitis, or Fournier gangrene, is a rare entity of high severity, progressive and with an important mortality rate. This pathology must be of interdisciplinary management where pharmacology and surgical therapy is covered. The following case presents a young adult with a history of paraplegia in septic shock related to a soft tissue infection in the perineal area, which is treated with antibiotic regimen plus early surgical debridement.
References
Ozkan O, Koksal N, Altinli E, Celik A, Uzun M, Cıkman O et al. Fournier's gangrene current approaches. International Wound Journal. 2014; 13(5):713-716.https://doi.org/10.1111/iwj.12357
Abass-Shereef J, Kovacs M, Simon E. Fournier's Gangrene Masking as Perineal and Scrotal Cellulitis. The American Journal of Emergency Medicine. 2018; 36(9): 1719.e1-1719.e2. https://doi.org/10.1016/j.ajem.2018.05.067
Yagüe D, Ángulo E, Bernal C, Marcuello M, Mayayo E, Sarria L. Gangrena perineal en mujer de 44 años: Hallazgos en Tomografía Axial Computarizada (TAC). Archivos Españoles de Urología. 2009; 62(6): 483-485. https://doi.org/10.4321/S0004-06142009000600007
Fuentes E, Núñez A, Kapaxi J, Fernandes Y. Gangrena de Fournier. Revista Cubana de Cirugía. 2011; 52(2): 91-100.Disponible en: http://www.revcirugia.sld.cu/index.php/cir/article/view/87/12
Singh A, Ahmed K, Aydin A, Khan M, Dasgupta P. Fournier's gangrene. A clinical review. Archivio Italiano di Urologia e Andrologia. 2016; 88(3):157-164. https://doi.org/10.4081/aiua.2016.3.157
Waldron C, Solon J, O'Gorman J, Humphreys H, Burke J, McNamara D. Necrotizing fasciitis: The need for urgent surgical intervention and the impact of intravenous drug use. The Surgeon. 2015; 13(4):194-199. https://doi.org/10.1016/j.surge.2014.01.005
Ana María Rodríguez Vera, Carlos Alberto Larios García, Guihovany Alberto García Casilimas, Iván Arturo Rodríguez Sabogal, José Luis López Pérez. Gangrena de Fournier. Revista Médica Sanitas. 2015; 18(4):212-219. Disponible en: https://www.unisanitas.edu.co/Revista/57/GANGRENA_DE_FOURNIER.pdf
Kumar A, Stiles E. Perineal soft tissue infections. Seminars in Colon and Rectal Surgery. 2019; 30(3):1-6. https://doi.org/10.1016/j.scrs.2019.100692
Hakkarainen T, Kopari N, Pham T, Evans H. Necrotizing soft tissue infections: Review and current concepts in treatment, systems of care, and outcomes. Current Problems in Surgery. 2014; 51(8):344-362. https://doi.org/10.1067/j.cpsurg.2014.06.001
Özşaker E, Yavuz M, Altınbaş Y, Şahin Köze B, Nurülke B. The care of a patient with Fournier's gangrene. Turkish Journal of Trauma and Emergency Surgery. 2015; 21(1):71-74. https://doi.org/10.5505/tjtes.2015.22735
Godinez A. Fascitis Necrotizante Perineal: Gangrena de Fournier. Revista Médica MD. 2011; 3(1):27-33. Disponible en: https://www.medigraphic.com/cgi-bin/new/resumen.cgi?IDARTICULO=38963
Lohsiriwat V. Anorectal emergencies. World Journal of Gastroenterology. 2016; 22(26):5867-5878.https://doi.org/10.3748/wjg.v22.i26.5867
Stevens D, Bryant A. Necrotizing Soft-Tissue Infections. New England Journal of Medicine. 2017; 377(23):2253-2265. https://doi.org/10.1056/NEJMra1600673
Hong K, Yi H, Lee R, Kim K, Chung S. Prognostic factors and treatment outcomes for patients with Fournier's gangrene: a retrospective study. International Wound Journal. 2017; 14(6):1352-1358. https://doi.org/10.1111/iwj.12812
Yilmazlar T, Gulcu B, Isik O, Ozturk E. Microbiological aspects of Fournier's gangrene. International Journal of Surgery. 2017; 40:135-138. https://doi.org/10.1016/j.ijsu.2017.02.067
Tian Y, Liu T, Zhao C, Lei Z, Fan D, Mao T. Negative pressure wound therapy and split thickness skin graft aided in the healing of extensive perineum necrotizing fasciitis without faecal diversion: a case report. BMC Surgery. 2018; 18(1):1-4. https://doi.org/10.1186/s12893-018-0411-6
Mizuguchi Y, Matsumoto S, Kan H, Koizumi M, Kuriyama S, Uchida E. Successful Treatment of Necrotizing Fasciitis after Rectal Surgery with the Application of a Negative pressure Wound Therapy: A Case Study. Journal of Nippon Medical School. 2015; 82(6):290-294. https://doi.org/10.1272/jnms.82.290
Korhonen K, Kuttila K, Niinikoski J. Tissue gas tensions in patients with necrotising fasciitis and healthy controls during treatment with hyperbaric oxygen: a clinical study. Eur J Surg 2000; 166:530-534. https://doi.org/10.1080/110241500750008583
Holena DN, Mills AM, Carr BG, Wirtalla C, Sarani B, Kim PK et al. Transfer status: a risk factor for mortality in patients with necrotizing fasciitis. Surgery 2011; 150:363-370. https://doi.org/10.1016/j.surg.2011.06.005
Cimsit M, Uzun G, Yildiz S. Hyperbaric oxygen therapy as an anti- infective agent. Expert Rev Anti Infect Ther 2009; 7:1015-1026. https://doi.org/10.1586/eri.09.76