title: [Our caseload in Fournier's disease].
abstract: We reviewed the records of 17 cases of Fournier's gangrene that had been diagnosed and treated in the Urology Service of the Marques de Valdecilla Hospital from 1982-1991. The series comprised male patients aged 32 to 77. Eleven cases (64.7%) were due to a known cause, above all infection. Most of the patients had factors that predisposed to the development and progression of the disease, predominantly diabetes mellitus (5 cases, 29.4%). The clinical features frequently corresponded to those of acute infection, with high fever, chills, pain, nausea and vomiting that could progress to a septic state. The local symptoms and signs included pain, swelling, erythema and necrosis, depending on the compromised area. Infection was usually caused by Gram-negative bacteria, particularly E. coli, although Gram-positive bacteria and anaerobes have been observed. Mixed bacterial infections have also been observed. Treatment must be instituted early using a combination of broad spectrum antibiotics that cover both aerobes and anaerobes, and wide surgical debridement of the compromised area. In some cases hyperbaric oxygen therapy may be warranted. The disease continues to be severe. In the present series, the outcome was favorable in 12 cases (70.5%) and there were 5 deaths (29.4%).
authors.affiliation: Servicio de Urología, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, España.
authors.forename: J M
authors.initials: JM
authors.lastname: Monge Mirallas
authors.forename: J A
authors.initials: JA
authors.lastname: Portillo Martín
authors.forename: B
authors.initials: B
authors.lastname: Martín García
authors.forename: R
authors.initials: R
authors.lastname: Hernández Rodríguez
authors.forename: M A
authors.initials: MA
authors.lastname: Correas Gómez
authors.forename: J L
authors.initials: JL
authors.lastname: Gutiérrez Baños
authors.forename: J M
authors.initials: JM
authors.lastname: Fernández Gómez
authors.forename: T
authors.initials: T
authors.lastname: Concepción Masip
mesh_terms: D000328:Adult; D000368:Aged; D001424:Bacterial Infections / Q000382:microbiology; D005734:Gangrene / Q000209:etiology / Q000601:surgery; D005832:Genital Diseases, Male / Q000209:etiology / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D010502:Perineum / Q000473:pathology*; D012611:Scrotum / Q000473:pathology*
vernacular_title: Nuestra casuística en la enfermedad de Fournier.