Articles Vol. 65 No. CĐ 4 - Hội Y học Giới tính Việt Nam 30/05/2024

28. RESULTS OF DIAGNOSIS AND TREATMENT OF FOURNIER'S GANGRENE AT 115 PEOPLE'S HOSPITAL FROM 2018 TO 2023

Nguyen Thanh Quang1,2, Truong Hoang Minh1,2,3,4, Pham Le Duy1,2, Ngo Quang Trung1,2, Tran Thanh Phong1,2, Le Dinh Hieu1,2,3,4
1 People's Hospital 115
2 Bệnh viện Nhân Dân 115
3 Pham Ngoc Thach University of Medicine
4 Trường Đại học Y khoa Phạm Ngọc Thạch
Corresponding author: vn.nguyenthanhquang@gmail.com
DOI: 10.52163/yhc.v65iCD4.1177
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Keywords
Fournier’s gangrene, necrosis, scrotum, penis, genital organs, perineum.
Abstract

Objective: To review the clinical characteristics, paraclinical features, treatment outcomes of Fournier’s gangrene, and some factors related to the mortality rate of Fournier’s gangrene patients at 115 People’s Hospital from 2018 to 2023.

Methods: Retrospective case series study: patients diagnosed with Fournier’s gangrene and treated at 115 People’s Hospital from January 2018 to May 2023.

Results: There were 30 patients (21 males and 09 females) diagnosed with FG and treated. The average age was 60.23 ± 14.34 (31 - 87 years old), mainly in the 40 - 70 age group. Skin infections accounted for the highest proportion at 43.3%, followed by gastrointestinal infections at 16.7%, and urogenital infections at 6.7%. Most patients had symptoms of perineal pain (100%), perineal swelling (66.7%), subcutaneous emphysema (46.7%), urinary retention (20%). FG on the basis of genitourinary diseases was the most common (56.6%). Pathogenic bacteria isolated under microbiological conditions at the hospital were predominantly anaerobic, with E. coli, Klebsiella and Proteus spp being the most common strains (21.9%). Active treatment included internal medicine (resuscitation, broad-spectrum antibiotics, nutrition, wound care, etc.) and surgery (surgical debridement of necrotic tissue, fecal and urinary diversion). The mortality rate of the study was 23.3%. Multiple organ failure and septic shock were the main contributing factors to death. Female gender, diabetes, high severity index, and extensive spread of FG lesions significantly influenced the mortality rate.

Conclusion: FG is a rare, rapidly progressing disease with a high mortality rate. Early treatment including resuscitation, antibiotic therapy, and prompt surgical debridement is as soon as possible.

References
[1]
El-Qushayri AE, Khalaf KM, Dahy A et Google Scholar
[2]
al., Fournier’s gangrene mortality: A 17- Google Scholar
[3]
year systematic review and meta-analysis. Google Scholar
[4]
International journal of infectious diseases : IJID Google Scholar
[5]
: official publication of the International Society Google Scholar
[6]
for Infectious Diseases. 2020;92:218-25. Google Scholar
[7]
Sorensen MD, Krieger JN, Rivara FP et Google Scholar
[8]
al., Fournier’s Gangrene: population based Google Scholar
[9]
epidemiology and outcomes. The Journal of Google Scholar
[10]
urology. 2009;181(5):2120-6. Google Scholar
[11]
Eke N, Fournier’s gangrene: a review of Google Scholar
[12]
cases. The British journal of surgery. Google Scholar
[13]
;87(6):718-28. Google Scholar
[14]
Malik, Arshad Mehmood et al., The Google Scholar
[15]
spectrum of presentation and management Google Scholar
[16]
of Fournier’s gangrene--an experience of 73 Google Scholar
[17]
cases. Hypertension, 2010, 4: 5.47. Google Scholar
[18]
Kuo CF, Wang WS, Lee CM et al., Fournier’s Google Scholar
[19]
gangrene: ten-year experience in a medical center Google Scholar
[20]
in northern Taiwan. Journal of microbiology, Google Scholar
[21]
immunology, and infection= Wei mian yu gan Google Scholar
[22]
ran za zhi, 40(6), 500-506, 2007. Google Scholar
[23]
Koukouras, Dimitrios et al., Fournier’s Google Scholar
[24]
gangrene, a urologic and surgical emergency: Google Scholar
[25]
presentation of a multi-institutional experience Google Scholar
[26]
with 45 cases. Urologia internationalis, 2011, Google Scholar
[27]
2: 167-172. Google Scholar
[28]
Basoglu, Mahmut et al., Management of Google Scholar
[29]
Fournier’s gangrene: review of 45 cases. Surgery Google Scholar
[30]
today, 2007, 37: 558-563. Google Scholar
[31]
Garcia Marin A, Turegano Fuentes F, Cuadrado Google Scholar
[32]
Ayuso M et al., Predictive factors for mortality Google Scholar
[33]
in Fournier’ gangrene: a series of 59 cases. Cir Google Scholar
[34]
Esp. 2015;93(1):12-7 Google Scholar
[35]
Hejase, Mohamed J et al., Genital Fournier’s Google Scholar
[36]
gangrene: experience with 38 patients. Urology, Google Scholar
[37]
, 47.5: 734-739. Google Scholar