Korean J Urogenit Tract Infect Inflamm.  2013 Apr;8(1):47-51. 10.14777/kjutii.2013.8.1.47.

Comparison between Fournier's Gangrene and Scrotal Abscess Using Fournier's Gangrene Severity Index

Affiliations
  • 1Department of Urology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea. dsryumd@skku.edu

Abstract

PURPOSE
To evaluate effective factors in the survival of patients with Fournier's gangrene (FG) and scrotal abscess, and to determine the validity of the Fournier's gangrene severity index (FGSI), which was designed for determining disease severity in these patients.
MATERIALS AND METHODS
Twenty-eight men who treated for FG were enrolled. The data were evaluated about medical history, extent of body surface area involved (%), and the FGSI, which index presents patients' vital signs (body temperature, heart and respiratory rates) and metabolic parameters (serum sodium, potassium, creatinine, bicarbonate, hematocrit, and white blood cell count). All the patients had antibiotic treatment and radical surgical debridement. The data were assessed according to whether the patient of FG survived or died, and also compared in patients with scrotal abscess (n=26).
RESULTS
Of the evaluated 28 FG patients, 6 died (21.4%). The difference in median age between survivors (57.5 years) and those who died (69.0 years) was not significant (p=0.18). Escherichia coli is the most common pathogen in 25% of FG and 15% of scrotal abscess patients. The median extent of the body surface area involved in patients who survived and died was 2.5% and 3.5%, respectively (p =0.13). However, the median FGSI scores for nonsurvivors and survivors of FG, and patients of scrotal abscess were 10.0+/-3.6, 3.3+/-2.6, and 0.9+/-2.6, respectively (p<0.01). The heart rate and serum creatinine level at the admission were significant prognostic parameters in patients with FG.
CONCLUSIONS
The FGSI score appeared to be predicts the disease severity and the patient's survival in patients with FG and scrotal abscess.

Keyword

Fournier; Prognosis; Therapeutics

MeSH Terms

Abscess*
Body Surface Area
Creatinine
Debridement
Escherichia coli
Fournier Gangrene*
Heart
Heart Rate
Hematocrit
Humans
Leukocytes
Male
Methods
Potassium
Prognosis
Sodium
Survivors
Vital Signs
Creatinine
Potassium
Sodium

Reference

1. Fournier JR. Gangrene foudroyante de la verge. Medicin Pratique. 1883; 4:597–8.
2. Spirnak JP, Resnick MI, Hampel N, Persky L. Fournier's gangrene: report of 20 patients. J Urol. 1984; 131:289–91.
3. Lim SD, Lee SJ, Jeong HJ. The study of prognostic factors in Fournier's gangrenes. Korean J Urol. 2002; 43:412–7.
4. Kim BH, Chang HS, Park CH, Kim CI, Kim KS. Necessity of aggressive management in fournier's gangrene. Korean J Urol. 2004; 45:793–9.
5. Weiner DM, Lowe FC. Gangrene of the male genitalia. AUA Update Series. 1998; 17:41–7.
6. Laor E, Palmer LS, Tolia BM, Reid RE, Winter HI. Outcome prediction in patients with Fournier's gangrene. J Urol. 1995; 154:89–92.
Article
7. Lin E, Yang S, Chiu AW, Chow YC, Chen M, Lin WC, et al. Is Fournier's gangrene severity index useful for predicting outcome of Fournier's gangrene? Urol Int. 2005; 75:119–22.
Article
8. Tuncel A, Aydin O, Tekdogan U, Nalcacioglu V, Capar Y, Atan A. Fournier's gangrene: Three years of experience with 20 patients and validity of the Fournier's Gangrene Severity Index Score. Eur Urol. 2006; 50:838–43.
Article
9. Hwang EC, Na SW, Kim YJ, Kim JS, Kim SO, Jung SI, et al. Fournier's gangrene: six years of experience with 33 patients and validity of the Fournier's gangrene severity index score in Korean patients. Korean J UTII. 2010; 5:199–206.
10. Curreri PW, Luterman A. Burns. Schwartz SI, Shires GT, Spencer FC, editors. Principles of surgery. 5th ed.New York: McGraw-Hill Book Co.;1989. p. 285–306.
11. Laucks SS 2nd. Fournier's gangrene. Surg Clin North Am. 1994; 74:1339–52.
Article
12. Eke N. Fournier's gangrene: a review of 1726 cases. Br J Surg. 2000; 87:718–28.
Article
13. Smith GL, Bunker CB, Dinneen MD. Fournier's gangrene. Br J Urol. 1998; 81:347–55.
Article
14. Palmer LS, Winter HI, Tolia BM, Reid RE, Laor E. The limited impact of involved surface area and surgical débridement on survival in Fournier's gangrene. Br J Urol. 1995; 76:208–12.
15. Korkut M, Icoz G, Dayangac M, Akgun E, Yeniay L, Erdogan O, et al. Outcome analysis in patients with Fournier's gangrene: report of 45 cases. Dis Colon Rectum. 2003; 46:649–52.
16. Steffen EK, Hentges DJ. Hydrolytic enzymes of anaerobic bacteria isolated from human infections. J Clin Microbiol. 1981; 14:153–6.
Article
17. Pizzorno R, Bonini F, Donelli A, Stubinski R, Medica M, Carmignani G. Hyperbaric oxygen therapy in the treatment of Fournier's disease in 11 male patients. J Urol. 1997; 158:837–40.
Article
18. Clayton MD, Fowler JE Jr, Sharifi R, Pearl RK. Causes, presentation and survival of fifty-seven patients with necrotizing fasciitis of the male genitalia. Surg Gynecol Obstet. 1990; 170:49–55.
19. Asci R, Sarikaya S, Buyukalpelli R, Yilmaz AF, Yildiz S. Fournier's gangrene: risk assessment and enzymatic debridement with lyophilized collagenase application. Eur Urol. 1998; 34:411–8.
20. Chawla SN, Gallop C, Mydlo JH. Fournier's gangrene: an analysis of repeated surgical debridement. Eur Urol. 2003; 43:572–5.
Article
21. Kilic A, Aksoy Y, Kilic L. Fournier's gangrene: etiology, treatment, and complications. Ann Plast Surg. 2001; 47:523–7.
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