Abstract

"Purpose: Fournier’s gangrene is a rare and potentially fatal infectious disease characterized by necrotic fasciitis of the perineum and abdominal wall, along with the scrotum and penis in men and the vulva in women. The aim of this study is to share our recent experience with the management of this difficult infectious disease. Materials and Methods: The authors reviewed retrospectively the clinical records of a series of 10 patients with Fournier’s gangrene between the years 2004 and 2007 who, after initial treatment. The patient’s age, predisposing etiological factors, interval between onset of symptoms and diagnosis, lesion site, results of bacteriologic cultures, treatment and reconstructive procedures, length of hospital stay, treatment and outcome were analyzed. Results: The patients' ages ranged between 46 and 84 years (mean 59 years). Of the 10 patients, 1 (10%) died and 9 (90%) survived. The predisposing factors included diabetes mellitus (10 cases, 100%), hypertention (3 cases, 30%), liver cirrhosis (2 cases, 20%), CVA (1 case, 10%). All 10 patients had positive culture results, with 9 (90%) of these being polymicrobial. The most common organisms isolated were Escherichia coli (n=6), Staphylococcus aureus (n=4) and Streptococcus agalactiae (n=2). The important finding wass the fact that quinolone-resistant extended spectrum beta-lactamase (ESBL) Escherichia coli (E. coli) was detected in two cases (20%). The mean length of hospital stay was 41.1 days (7-70). Conclusions: There is no differences between current study and previous, butit is important that ESBL producing E. coli was appeared. It may have influence on length of hospital stay and wound healing. However, more studies are required to conclusively prove the effect of ESBL on prognosis of Fournier’s gangrene."

• Keywords: Fournier';s gangrene, Management, Extended spectrum beta-lactamase (ESBL)