Fournier’s Gangrene: A Study of 14 Cases

Abstract

Introduction: Fournier’s Gangrene (FG) is a life-threatening form of infective necrotising fasciitis affecting the genital, perineal or perianal regions. Men are mostly affected though women and children may also be affected. Despite aggressive treatment, the mortality rate of FG remains high. Aim: To study demographic pattern of FG, its predisposing factors and aetiological agents, locations of infective gangrene and outcomes of treatment in a geographical area. Materials and Methods: This retrospective study included data of 14 patients of FG admitted to the surgical units of the Institute with FG, between July 2017 to June 2019, which were analysed. The commonly affected sites, predisposing factors, causative organisms, and outcomes of management of FG were studied. Results: All the 14 patients were males; their mean age was 54.57 years (28-75 years). The mean duration from the onset of symptoms to admission to the hospital was 6.7 days (2-11 days). The mean hospitalisation time was 22.6 days (2-35 days). Six (42.86%) and 3 (21.43%) patients had FG secondary to perianal and scrotal infections respectively. Diabetes mellitus as a predisposing factor was found in 9 (64.29%) patients. There was no definite predisposing or co-morbid condition in 3 (21.43%) patients. The most frequent bacterial organism was Escherichia coli in 11 (78.57%) patients. The overall mortality was 5 (35.71%) out of the 14 patients. Mortality was highest in patients presenting with sepsis and diabetes mellitus. Conclusion: FG is a rapidly progressive, fulminant infection. In spite of aggressive surgical approach and broad spectrum antimicrobial combinations, the prognosis remains grave especially when it is associated with diabetes mellitus and sepsis.

Keywords

• debridement
• diabetes mellitus
• necrotising fasciitis
• polymicrobial