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RMJ. 2013; 38(2): 160-164


Etiological factors and treatment outcome of genital and perineal necrotizing fascitis (Fournier’s Gangrene)

Khush Muhammad Sohu, Azhar Ali Shah, Shahid Hussain Mirani, Ghulam Hyder Rind, Bushra Shaikh.

Abstract
Introduction: Fournier’s gangrene (FG) is the necrotizing fasciitis of the perineum and genital area with high mortality. This condition is more commonly seen in patients with uncontrolled diabetes mellitus. Patients and Methods: A retrospective review of 82 patients, diagnosed with FG from January 2007 to December 2011 was made & divided into two groups- those who survived (survivors) and those who did not (nonsurvivors). We analyzed clinical and laboratory data. Results: The mortality rate remained 36.6% (30/82 patients). Increased heart and respiratory rates, elevated serum creatinine, pre-existing kidney disease, and higher extent of affected body surface were associated with higher mortality. Severe sepsis on admission and hypotension below 90 mm Hg were also predictive for higher mortality. The median FG severity index (FGSI) score was higher in nonsurvivors (22 compared to 12, p < 0.0001). Conclusion: Besides standard clinical and laboratory parameters included in the FGSI calculation, higher extent of affected body surface area and presence of hypotension on admission were also positively associated with mortality. Early clinical identification & prompt aggressive treatment are essential for reducing mortality & morbidity in patients with this disease.

Key words: Fournier’s gangrene, Necrotizing fasciitis, surgical emergency, Severity index.



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