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__NOTOC__
__NOTOC__
{{SI}}
'''For more information about necrotizing fasciitis click [[necrotizing fasciitis|here]]
'''For patient information, click [[Fournier gangrene (patient information)|here]]'''
{{Fournier gangrene}}
{{SCC}}; {{AE}} {{YK}}; {{JH}}
{{SCC}}; {{AE}} {{YK}}; {{JH}}
{{SK}} Fournier's gangrene; Idiopathic gangrene of scrotum; Periurethral phlegmon; Streptococcal scrotal gangrene; Genito-perineal gangrene; Phagedena


{{Search infobox}}
{{Search infobox}}
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  | MeshID        = D018934
  | MeshID        = D018934
}}
}}
==[[Fournier gangrene overview|Overview]]==


==Overview==
==[[Fournier gangrene historical perspective|Historical Perspective]]==
'''Fournier gangrene''' is a type of [[necrosis|necrotizing]] [[infection]] ([[gangrene]]) usually affecting the male [[genital]]s. It is a type of [[necrotizing fasciitis]]. It was first described by Baurienne in 1764 and is named after a French [[venereology|venereologist]], Jean-Alfred Fournier following five cases he presented in clinical lectures in 1883.
 
==Historical Perspective==
 
==Classification==


==Pathophysiology==
==[[Fournier gangrene classification scheme|Classification]]==


==Causes==
==[[Fournier gangrene pathophysiology|Pathophysiology]]==
===Aetiology===
In the majority of cases Fournier gangrene is a mixed infection caused by both [[aerobic]] and [[anaerobic]] bacteria.<ref>{{cite journal |author=Thwaini A, Khan A, Malik A, Cherian J, Barua J, Shergill I, Mammen K |title=Fournier's gangrene and its emergency management |journal=Postgrad Med J |volume=82 |issue=970 |pages=516-9 |year=2006 |id=PMID 16891442}}</ref>


==Differentiating {{PAGENAME}} from Other Diseases==
==[[Fournier gangrene causes|Causes]]==


==Epidemiology and Demographics==
==[[Differentiating Fournier gangrene from other diseases|Differentiating Fournier gangrene from other Diseases]]==
===Incidence===
Only 600 cases of Fournier gangrene were reported in the world literature in the ten years since 1996, with most patients in their 60s or 70s with other concurrent illnesses.<ref>{{cite journal |author=Vaz I |title=Fournier gangrene |journal=Trop Doct |volume=36 |issue=4 |pages=203-4 |year=2006 |id=PMID 17034687}}</ref> However, Fournier's gangrene is not a reportable illness, and the condition is not uncommon, especially among diabetic individuals. A similar infection in women has been occasionally described.<ref>{{cite journal |author=Herzog W |title=[Fournier gangrene--also in females?] |journal=Zentralbl Chir |volume=112 |issue=9 |pages=564-76 |year=1987 |id=PMID 2956804}} </ref>


In Turkey it was reported that 46% of patients had [[diabetes mellitus]]<ref name="Yanar2006">{{cite journal |author=Yanar H, Taviloglu K, Ertekin C, Guloglu R, Zorba U, Cabioglu N, Baspinar I |title=Fournier's gangrene: risk factors and strategies for management |journal=World J Surg |volume=30 |issue=9 |pages=1750-4 |year=2006 |id=PMID 16927060}}</ref> whilst other studies have identified approximately a third of patients having either diabetes, alcoholism or malnutrition, and 10% having medical immunosuppression (chemotherapy, steroids, malignancy).<ref>{{cite journal |author=Tahmaz L, Erdemir F, Kibar Y, Cosar A, Yalcýn O |title=Fournier's gangrene: report of thirty-three cases and a review of the literature |journal=Int J Urol |volume=13 |issue=7 |pages=960-7 |year=2006 |id=PMID 16882063}}</ref>
==[[Fournier gangrene epidemiology and demographics|Epidemiology and Demographics]]==


==Risk Factors==
==[[Fournier gangrene risk factors|Risk Factors]]==


==Screening==
==[[Fournier gangrene screening|Screening]]==


==Natural History, Complications, and Prognosis==
==[[Fournier gangrene natural history, complications and prognosis|Natural History, Complications and Prognosis]]==


==Diagnosis==
==Diagnosis==
===Diagnostic Criteria===
[[Fournier gangrene diagnostic criteria|Diagnostic criteria]] | [[Fournier gangrene history and symptoms|History and Symptoms]] | [[Fournier gangrene physical examination|Physical Examination]] | [[Fournier gangrene laboratory tests|Laboratory Findings]] | [[Fournier gangrene electrocardiogram|Electrocardiogram]] | [[Fournier gangrene x ray|X-Ray Findings]] | [[Fournier gangrene CT|CT-Scan Findings]] | [[Fournier gangrene MRI|MRI Findings]] | [[Fournier gangrene ultrasound or echocardiography|Echocardiography and Ultrasound]] | [[Fournier gangrene other diagnostic studies|Other Diagnostic Studies]] | [[Fournier gangrene other imaging findings|Other Imaging Findings]]
 
===History and Symptoms===
 
 
===Physical examination===
====Gallery====
=====Genitourinary system=====
 
<gallery>
 
Image: Fournier's_gangrene_01.jpeg|Fournier's gangrene. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12  With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=157>
 
Image: Fournier's_gangrene_02.jpeg|Fournier's gangrene. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12  With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=157>
 
Image: Fournier's_gangrene_03.jpeg|Fournier's gangrene. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12  With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=157>
 
Image: Fournier's_gangrene_04.jpeg|Fournier's gangrene. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12  With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=157>
 
Image: Fournier's_gangrene_05.jpeg|Fournier's gangrene. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12  With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=157>
 
</gallery>
 
===Laboratory Findings===
 
===Imaging Findings===
 
===Other Diagnostic Studies===


==Treatment==
==Treatment==
===Medical Therapy===
[[Fournier gangrene medical therapy|Medical Therapy]] | [[Fournier gangrene surgery|Surgery]] | [[Fournier gangrene primary prevention|Primary Prevention]] | [[Fournier gangrene secondary prevention|Secondary Prevention]] | [[Fournier gangrene cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Fournier gangrene future or investigational therapies|Future or Investigational Therapies]]
Fournier gangrene is a urological emergency requiring intravenous antibiotics and debridement (surgical removal) of necrotic (dead) tissue. Despite such measures, the mortality rate overall is 40%, but 78% if [[sepsis]] is already present at the time of initial hospital admission.<ref name="Yanar2006"/>
====Antimicrobial Therapy====
* Fournier gangrene<ref>{{cite book | last = Gilbert | first = David | title = The Sanford guide to antimicrobial therapy | publisher = Antimicrobial Therapy | location = Sperryville, Va | year = 2015 | isbn = 978-1930808843 }}</ref>
:* '''If caused by streptococcus species or clostridia'''
::* Preferred regimen: [[Penicillin G]]  
:* '''Polymicrobial'''


::* Preferred regimen: [[Doripenem]] {{or}} [[imipenem]] {{or}} [[meropenem]]
==Case Studies==
:* '''MRSA (methicillin resistant staphylococcus aureus) suspected'''
[[Fournier gangrene case study one|Case #1]]
 
[[Category:Emergency mdicine]]
::* Preferred regimen: [[vancomycin]] {{or}} [[daptomycin]]
[[Category:Disease]]
 
===Surgery===
 
===Prevention===
 
==External links==
* {{WhoNamedIt2|synd|2521|Fournier gangrene}} and {{WhoNamedIt|doctor|2209|Jean Alfred Fournier}}
 
==References==
{{reflist|2}}


[[Category:Up-To-Date]]
[[Category:Infectious disease]]
[[Category:Surgery]]
[[Category:Orthopedics]]
[[Category:Dermatology]]
[[Category:Dermatology]]
{{WH}}
{{WS}}

Latest revision as of 06:33, 28 July 2020

For more information about necrotizing fasciitis click here For patient information, click here

Fournier gangrene Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Fournier gangrene from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Criteria

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X Ray

CT

MRI

Echocardiography or Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Lupus and Quality of Life

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

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Risk calculators and risk factors for Fournier gangrene

Steven C. Campbell, M.D., Ph.D.; Associate Editor(s)-in-Chief: Yamuna Kondapally, M.B.B.S[1]; Jesus Rosario Hernandez, M.D. [2]

Synonyms and keywords: Fournier's gangrene; Idiopathic gangrene of scrotum; Periurethral phlegmon; Streptococcal scrotal gangrene; Genito-perineal gangrene; Phagedena

Template:Search infobox

Fournier gangrene
ICD-10 N49.8 (ILDS N49.81), N76.8
ICD-9 608.83
DiseasesDB 31119
MeSH D018934

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Fournier gangrene from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic criteria | History and Symptoms | Physical Examination | Laboratory Findings | Electrocardiogram | X-Ray Findings | CT-Scan Findings | MRI Findings | Echocardiography and Ultrasound | Other Diagnostic Studies | Other Imaging Findings

Treatment

Medical Therapy | Surgery | Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

Case Studies

Case #1

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