[Septic shock in a patient with the Fournièr gangrene with fatal outcome].
OBJECTIVE
The authors present a case of a patient with developed Fournièr gangrene and septic shock. Fournièr gangrene belongs to the group of local non-specific infection of soft tissues (NSTI). Its incidence is relatively low, but the infection is extraordinary aggressive with a possible lethal end.


METHODS
39 years old patient with 4 days history of Fournier gangrene's development was admitted in irreversible septic shock. The initial APACHE II score was 36. The delay in treatment was an important factor in the further course of illness with lethal end.


RESULTS
Above the mentioned 39 years old patient died because of septic shock. The hemorrhagic cystitis was the original source of infection with further development of Fournièr gangrene according to the pathological record.


CONCLUSIONS
We often come across all different kinds of stages of sepsis from the MODS to the septic shock for patients with Fournièr gangrene. Causal treatment should be started early. The local surgical excision and wide broad antibiotic administrations are basic treatments in the context of other treatment modalities according to the current patient's needs. The adjuvant hyperbaric oxygen treatment takes place in patients with Fournièr gangrene as well and is beneficial. The following factor even worsens the illness prognosis: delay in diagnostic, higher age, anorectal origin of infection, the amount of organ with dysfunction or failure, diabetes mellitus and significant immunodeficiency.
Zonca
P
P
Chirurgické a traumatologické oddelení, MN Ostrava. pavel.zonca@hotmail.co.uk
Mrázek
T
T
Matusek
A
A
Hajek
M
M
Stiglerová
S
S
Jurytko
A
A
Kucera
C
C
Nieslanik
M
M
D000328:Adult; D017809:Fatal Outcome; D018934:Fournier Gangrene / Q000150:complications*; D006801:Humans; D008297:Male; D012772:Shock, Septic / Q000209:etiology*