title: Systemic corticosteroids are important in the treatment of Fournier's gangrene: a case report.
abstract: Fournier's gangrene represents an acute severe necrotizing inflammatory process affecting the scrotum and penis. It has an associated mortality of 30-50%. In most cases, aetiological factors can be identified, such as diabetes mellitus, chronic alcoholism and perianal, perirectal or periurethral infection. The disease is characterized by a polybacterial infection, and the classic treatment includes surgical removal of the necrotic tissue and the use of broad-spectrum antibiotics. We report a case of Fournier's gangrene, histologically characterized by a necrotizing vasculitis, in which surgical resection of the necrotic tissue and antibiotic treatment failed to halt progression of the disease, whereas complete remission was achieved by high-dose corticosteroid therapy. This suggests that Fournier's gangrene is related to some form of localized vasculitis, and represents a local Shwartzman phenomenon.
authors.affiliation: Department of Dermatology, Friedrich-Alexander-University Erlangen-Nuremberg, Germany.
authors.forename: E S
authors.initials: ES
authors.lastname: Schultz
authors.forename: T L
authors.initials: TL
authors.lastname: Diepgen
authors.forename: P
authors.initials: P
authors.lastname: von den Driesch
authors.forename: O P
authors.initials: OP
authors.lastname: Hornstein
mesh_terms: D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D018934:Fournier Gangrene / Q000188:drug therapy* / Q000473:pathology; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use*; D008875:Middle Aged
chemical_list: D000893:Anti-Inflammatory Agents; D005938:Glucocorticoids; D008775:Methylprednisolone