Diagnosis and treatment of an unusual cause of sepsis in a diabetic patient: a Fournier's gangrene.
Actually, the Fournier's gangrene is described as a dermohypodermitis of the perineal, genital and/or perianal regions which can affect both sexes and a wide range of ages. The diagnosis of the disease is essentially made on clinical grounds. Imagery can be interesting in case of an intra-abdominal suspected source of the infection, uncertain diagnosis and good available trechniques. Surgery is the only potential curative therapy and the delay between its application and the beginning of the symptoms is the most predictive prognostic factor. Adjuvant treatments consist of broad spectrum antibiotherapy, hyperbaric oxygenotherapy and topical treatments have been proposed in order to improve the prognosis of these patients, which has remained relatively dark and unchanged for thirty years. The efficiency of such therapeutics are difficult to assess because all available studies do not meet the classical criteria of evidence-based medicine.
Maréchal
R
R
Service de Gastroentérologie, C.H.U. Tivoli, Université Libre de Bruxelles, Belgique. rafmarechal@hotmail.com
Taccone
F
F
D015897:Comorbidity; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D005260:Female; D018934:Fournier Gangrene / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology / Q000601:surgery*; D005831:Genital Diseases, Female / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D016867:Immunocompromised Host; D008875:Middle Aged