title: Fournier's gangrene after hemorrhoidectomy: association with drug-induced agranulocytosis. Report of a case.
abstract: An unusual case of Fournier's gangrene after hemorrhoidectomy and drug-induced agranulocytosis, as the predisposing condition, is described. The patient had severe granulocytopenia that was attributed to the recent use of dipyrone. Together with hemodynamic resuscitation, broad-spectrum antibiotic and recombinant human granulocyte colony-stimulating factor were started. Wide surgical excision of all the gangrenous tissues, in addition to laparoscopic formation of a defunctioning sigmoid loop colostomy, was performed. The white blood cell count rose steadily and the patient experienced a rapid recovery. We emphasize that radical surgery must be accompanied by pharmacologic interventions for a successful outcome in such cases.
authors.affiliation: Department of Surgery, Gazi University Medical School, Ankara, Turkey.
authors.forename: A
authors.initials: A
authors.lastname: Cihan
authors.forename: B B
authors.initials: BB
authors.lastname: Menteş
authors.forename: G
authors.initials: G
authors.lastname: Sucak
authors.forename: A
authors.initials: A
authors.lastname: Karamercan
authors.forename: R
authors.initials: R
authors.lastname: Naznedar
authors.forename: Z
authors.initials: Z
authors.lastname: Ferahköşe
mesh_terms: D000328:Adult; D000380:Agranulocytosis / Q000139:chemically induced*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D012809:Colon, Sigmoid / Q000601:surgery; D003125:Colostomy; D004177:Dipyrone / Q000009:adverse effects*; D005440:Fluid Therapy; D018934:Fournier Gangrene / Q000209:etiology* / Q000601:surgery; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use; D006484:Hemorrhoids / Q000601:surgery*; D006801:Humans; D015378:Imipenem / Q000627:therapeutic use; D010535:Laparoscopy; D008297:Male; D011183:Postoperative Complications / Q000601:surgery; D011994:Recombinant Proteins; D012307:Risk Factors; D013845:Thienamycins / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D011994:Recombinant Proteins; D013845:Thienamycins; D016179:Granulocyte Colony-Stimulating Factor; D004177:Dipyrone; D015378:Imipenem