Fournier's Gangrene - A Case Report with a Review of the Literature

Hristo Mangarov; Valentina Broshtilova; Atanas Batashki; Svetlana Bezhanova; Yoanna Velevska; Petar Vatov; Irina Yungareva; Sonya Marina

doi:doi:10.11648/j.ijcd.20230602.12

Fournier's Gangrene - A Case Report with a Review of the Literature

Hristo Mangarov, Valentina Broshtilova, Atanas Batashki, Svetlana Bezhanova, Yoanna Velevska, Petar Vatov, Irina Yungareva, Sonya Marina

Published in International Journal of Clinical Dermatology (Volume 6, Issue 2)

Received: 14 August 2023 Accepted: 4 September 2023 Published: 13 September 2023

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Abstract

Fournier's gangrene is a rare form of necrotizing fasciitis, also known as "flesh-eating disease." It cause extensive necrosis of skin, fascia, and subcutaneous of the external genitalia, perineal and perianal areas. The etiology is usually polymicrobial. Initial dermatological symptoms may be missing or mimicking erysipelas, cellulite or abscess. The disease is life-threatening with fulminant onset and prominent intoxication symptoms. Early diagnosis, complex treatment and urgent surgical debridement are crucial in reducing lethal outcome. We describe a case of a 38-year-old man with fever, erythema, edema and severe pain in his testicles and perineum 4 days before hospitalization. He was with poor general condition. The patient had a history of recent Covid-19 infection that worsened his metabolic syndrome and chronic pulmonary obstructive disease. Blood tests showed leukocytosis and extremely elevated C-reactive protein, and microbiological plating - beta streptococci and Staphylococcus aureus. Broad-spectrum antibiotics, aggressive debridement, adequate resuscitation and local treatment of the wound provided fast recovery and favourable outcome. An overview of the epidemiology, risk factors, etiological microorganisms, clinical picture, systemic and local complications, psychological problems, laboratory and imaging diagnostic methods of Fournier's gangrene is presented. Fournier’s gangrene and necrotizing fasciitis clinical risk assessment systems are also highlighted. Most appropriate therapeutic modalities are comprehensively discussed.

Published in	International Journal of Clinical Dermatology (Volume 6, Issue 2)
DOI	10.11648/j.ijcd.20230602.12
Page(s)	18-23
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Fournier’s Gangrene, Life-Threatening Condition, Fasciotomy

References

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APA Style

Hristo Mangarov, Valentina Broshtilova, Atanas Batashki, Svetlana Bezhanova, Yoanna Velevska, et al. (2023). Fournier's Gangrene - A Case Report with a Review of the Literature. International Journal of Clinical Dermatology, 6(2), 18-23. https://doi.org/10.11648/j.ijcd.20230602.12

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ACS Style

Hristo Mangarov; Valentina Broshtilova; Atanas Batashki; Svetlana Bezhanova; Yoanna Velevska, et al. Fournier's Gangrene - A Case Report with a Review of the Literature. Int. J. Clin. Dermatol. 2023, 6(2), 18-23. doi: 10.11648/j.ijcd.20230602.12

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AMA Style

Hristo Mangarov, Valentina Broshtilova, Atanas Batashki, Svetlana Bezhanova, Yoanna Velevska, et al. Fournier's Gangrene - A Case Report with a Review of the Literature. Int J Clin Dermatol. 2023;6(2):18-23. doi: 10.11648/j.ijcd.20230602.12

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@article{10.11648/j.ijcd.20230602.12,
  author = {Hristo Mangarov and Valentina Broshtilova and Atanas Batashki and Svetlana Bezhanova and Yoanna Velevska and Petar Vatov and Irina Yungareva and Sonya Marina},
  title = {Fournier's Gangrene - A Case Report with a Review of the Literature},
  journal = {International Journal of Clinical Dermatology},
  volume = {6},
  number = {2},
  pages = {18-23},
  doi = {10.11648/j.ijcd.20230602.12},
  url = {https://doi.org/10.11648/j.ijcd.20230602.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcd.20230602.12},
  abstract = {Fournier's gangrene is a rare form of necrotizing fasciitis, also known as "flesh-eating disease." It cause extensive necrosis of skin, fascia, and subcutaneous of the external genitalia, perineal and perianal areas. The etiology is usually polymicrobial. Initial dermatological symptoms may be missing or mimicking erysipelas, cellulite or abscess. The disease is life-threatening with fulminant onset and prominent intoxication symptoms. Early diagnosis, complex treatment and urgent surgical debridement are crucial in reducing lethal outcome. We describe a case of a 38-year-old man with fever, erythema, edema and severe pain in his testicles and perineum 4 days before hospitalization. He was with poor general condition. The patient had a history of recent Covid-19 infection that worsened his metabolic syndrome and chronic pulmonary obstructive disease. Blood tests showed leukocytosis and extremely elevated C-reactive protein, and microbiological plating - beta streptococci and Staphylococcus aureus. Broad-spectrum antibiotics, aggressive debridement, adequate resuscitation and local treatment of the wound provided fast recovery and favourable outcome. An overview of the epidemiology, risk factors, etiological microorganisms, clinical picture, systemic and local complications, psychological problems, laboratory and imaging diagnostic methods of Fournier's gangrene is presented. Fournier’s gangrene and necrotizing fasciitis clinical risk assessment systems are also highlighted. Most appropriate therapeutic modalities are comprehensively discussed.},
 year = {2023}
}

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TY - JOUR
T1 - Fournier's Gangrene - A Case Report with a Review of the Literature
AU - Hristo Mangarov
AU - Valentina Broshtilova
AU - Atanas Batashki
AU - Svetlana Bezhanova
AU - Yoanna Velevska
AU - Petar Vatov
AU - Irina Yungareva
AU - Sonya Marina
Y1 - 2023/09/13
PY - 2023
N1 - https://doi.org/10.11648/j.ijcd.20230602.12
DO - 10.11648/j.ijcd.20230602.12
T2 - International Journal of Clinical Dermatology
JF - International Journal of Clinical Dermatology
JO - International Journal of Clinical Dermatology
SP - 18
EP - 23
PB - Science Publishing Group
SN - 2995-1305
UR - https://doi.org/10.11648/j.ijcd.20230602.12
AB - Fournier's gangrene is a rare form of necrotizing fasciitis, also known as "flesh-eating disease." It cause extensive necrosis of skin, fascia, and subcutaneous of the external genitalia, perineal and perianal areas. The etiology is usually polymicrobial. Initial dermatological symptoms may be missing or mimicking erysipelas, cellulite or abscess. The disease is life-threatening with fulminant onset and prominent intoxication symptoms. Early diagnosis, complex treatment and urgent surgical debridement are crucial in reducing lethal outcome. We describe a case of a 38-year-old man with fever, erythema, edema and severe pain in his testicles and perineum 4 days before hospitalization. He was with poor general condition. The patient had a history of recent Covid-19 infection that worsened his metabolic syndrome and chronic pulmonary obstructive disease. Blood tests showed leukocytosis and extremely elevated C-reactive protein, and microbiological plating - beta streptococci and Staphylococcus aureus. Broad-spectrum antibiotics, aggressive debridement, adequate resuscitation and local treatment of the wound provided fast recovery and favourable outcome. An overview of the epidemiology, risk factors, etiological microorganisms, clinical picture, systemic and local complications, psychological problems, laboratory and imaging diagnostic methods of Fournier's gangrene is presented. Fournier’s gangrene and necrotizing fasciitis clinical risk assessment systems are also highlighted. Most appropriate therapeutic modalities are comprehensively discussed.
VL - 6
IS - 2
ER -

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Author Information

Hristo Mangarov

Department of Dermatology and Venereology, Medical Institute of the Ministry of Internal Affairs, Sofia, Bulgaria
Valentina Broshtilova

Department of Dermatology and Venereology, Eurohealth Clinic, Sofia, Bulgaria
Atanas Batashki

Department of Special Surgery, Medical University, Plovdiv, Bulgaria
Svetlana Bezhanova

Department of Gastroenterology, Medical Institute of the Ministry of Internal Affairs, Sofia, Bulgaria
Yoanna Velevska

Department of Infectious Diseases, Parasitology and Dermatovenereology, Medical University, Varna, Bulgaria
Petar Vatov

Department of Surgical Diseases, Unit of Urology, Medical University, Varna, Bulgaria
Irina Yungareva

Department of Dermatology and Venereology, Medical Institute of the Ministry of Internal Affairs, Sofia, Bulgaria
Sonya Marina

Department of Dermatology and Venereology, Medical Institute of the Ministry of Internal Affairs, Sofia, Bulgaria

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APA Style

Hristo Mangarov, Valentina Broshtilova, Atanas Batashki, Svetlana Bezhanova, Yoanna Velevska, et al. (2023). Fournier's Gangrene - A Case Report with a Review of the Literature. International Journal of Clinical Dermatology, 6(2), 18-23. https://doi.org/10.11648/j.ijcd.20230602.12

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ACS Style

Hristo Mangarov; Valentina Broshtilova; Atanas Batashki; Svetlana Bezhanova; Yoanna Velevska, et al. Fournier's Gangrene - A Case Report with a Review of the Literature. Int. J. Clin. Dermatol. 2023, 6(2), 18-23. doi: 10.11648/j.ijcd.20230602.12

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AMA Style

Hristo Mangarov, Valentina Broshtilova, Atanas Batashki, Svetlana Bezhanova, Yoanna Velevska, et al. Fournier's Gangrene - A Case Report with a Review of the Literature. Int J Clin Dermatol. 2023;6(2):18-23. doi: 10.11648/j.ijcd.20230602.12

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@article{10.11648/j.ijcd.20230602.12,
  author = {Hristo Mangarov and Valentina Broshtilova and Atanas Batashki and Svetlana Bezhanova and Yoanna Velevska and Petar Vatov and Irina Yungareva and Sonya Marina},
  title = {Fournier's Gangrene - A Case Report with a Review of the Literature},
  journal = {International Journal of Clinical Dermatology},
  volume = {6},
  number = {2},
  pages = {18-23},
  doi = {10.11648/j.ijcd.20230602.12},
  url = {https://doi.org/10.11648/j.ijcd.20230602.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcd.20230602.12},
  abstract = {Fournier's gangrene is a rare form of necrotizing fasciitis, also known as "flesh-eating disease." It cause extensive necrosis of skin, fascia, and subcutaneous of the external genitalia, perineal and perianal areas. The etiology is usually polymicrobial. Initial dermatological symptoms may be missing or mimicking erysipelas, cellulite or abscess. The disease is life-threatening with fulminant onset and prominent intoxication symptoms. Early diagnosis, complex treatment and urgent surgical debridement are crucial in reducing lethal outcome. We describe a case of a 38-year-old man with fever, erythema, edema and severe pain in his testicles and perineum 4 days before hospitalization. He was with poor general condition. The patient had a history of recent Covid-19 infection that worsened his metabolic syndrome and chronic pulmonary obstructive disease. Blood tests showed leukocytosis and extremely elevated C-reactive protein, and microbiological plating - beta streptococci and Staphylococcus aureus. Broad-spectrum antibiotics, aggressive debridement, adequate resuscitation and local treatment of the wound provided fast recovery and favourable outcome. An overview of the epidemiology, risk factors, etiological microorganisms, clinical picture, systemic and local complications, psychological problems, laboratory and imaging diagnostic methods of Fournier's gangrene is presented. Fournier’s gangrene and necrotizing fasciitis clinical risk assessment systems are also highlighted. Most appropriate therapeutic modalities are comprehensively discussed.},
 year = {2023}
}

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