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Fournier's gangrene (ZF) is an inflammation of the scrotum that also affects the penis, groin or buttocks, which can spread and lead to soft tissue necrosis. What are the causes and symptoms of Fourier's gangrene? How is the treatment going?

Fournier gangrene(ZF, Fournier gangrene) is caused by a variety of microorganisms, mainly aerobic and anaerobic bacteria. Although the incidence of this disease is low, it is fatal in many cases.

Fournier's gangrene - causes

Fournier's gangrene is caused by infections with many pathogens, incl. aerobic and anaerobic bacteria, and even fungi. Of these, the most common areE. coli ,Bacterioides , staphylococci and β-hemolytic streptococci.

The onset of infection is most often associated with damage to the skin (genital area) through which pathogens can enter the body.

Fournier's gangrene causes inflammation, subsequent vascular thrombosis and tissue necrosis.

Aerobic bacteria activate the coagulation cascade, which leads to platelet aggregation. Anaerobic bacteria produce heparinases and a gas that causes the characteristic symptom of crepitus or crackling. Thrombosis of blood vessels leads to the development of tissue necrosis.

Fournier's gangrene - symptoms

Non-specific symptoms appear at the beginning of Founier's gangrene:

  • weakness
  • high temperature
  • chills
  • nausea
  • vomiting

May be accompanied by pain in the perineum, itching and burning.

There is tachycardia due to elevated temperature, disturbed blood glucose levels, vascular collapse may occur. Red, painful scrotum and wounds are quite characteristic symptoms of Founier's gangrene.

Fournier's gangrene - predisposing factors

Factors predisposing to Fournier's gangrene are:

  • sex - Fournier necrosis occurs mainly in men, about 10% of cases are in women
  • diabetes - urinary tract infections may become more frequent due to urinary retention. With hyperglycemia, cellular immunity decreases, so the immune system does not function properly and does not properly defend itself against invading microbes.Blood circulation is also disturbed and wound healing is impeded, and such conditions favor the development of necrosis.
  • alcoholism
  • malnutrition
  • chronic steroid therapy
  • chemotherapy

Fournier's gangrene - recognition

Important tests prescribed by your doctor include:

  • bacteriological examination - while treating the wound, fluid and tissue fragments are collected for examination. This is to identify the infectious organism in order to select the correct antibiotic.
  • blood count
  • urea and creatinine test
  • electrolyte test
  • INR, PT, PTT - to be tested preoperatively

The imaging tests that a doctor can use in the diagnosis of Fournier's gangrene include:

  • X-ray examination of the abdominal cavity and pelvis
  • USG (the appearance of a hyperacoustic shadow indicates the presence of gas)
  • computed tomography, magnetic resonance imaging - rarely used

Fournier's gangrene - treatment

The most important in the treatment of Fournier's necrosis is excision of necrotic lesions, incision of abscesses, drainage and administration of intravenous antibiotics.

Surgical removal of the tissues is necessary as antibiotics will not work on the affected area. The procedure is performed under general anesthesia. It may be necessary to perform further treatments.

Zgorzel Fournier - supportive treatment

Hyperbaric oxygen therapy and negative pressure therapy significantly improve the treatment outcomes of patients with Fournier's gangrene.

The high oxygen content in the blood during hyperbaric treatment inhibits the spread of bacteria. This gives the antibiotics more time to act. Early application of this method reduces the mortality rate in Fournier's gangrene and increases the likelihood of a reduction in the development of necrosis.

Vacuum therapy, on the other hand, consists in replacing an ordinary dressing with one in which there is space for creating a negative pressure and removing the exudate. It is also important to use topical medications after surgery.

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Category:

Male diseases