Fournier's gangrene: our experience in 5 years, bibliographic review and assessment of the Fournier's gangrene severity index.
OBJECTIVE
Fournier's gangrene is a devastating infection, which includes the genital, perineal and/or perianal regions. It is potentially fatal, and affects any age and gender. The severity index for Fournier's gangrene has been described; it is useful for evaluating the prognosis of these patients. Our goal is to report our experience with this disease over the past 5 years and evaluate the index in retrospect.


METHODS
We analyzed medical records of patients with Fournier gangrene over the last 5 years at the University Hospital "Dr. José E. González".


RESULTS
We reviewed 50 cases, male gender was predominant (96%), mean age 47.5 years, diabetes mellitus was found in 80%, neurogenic bladder in 10%, 2% HIV positive. The most frequent sites of origin of infection were scrotum (52%) and perineum (38%), the most common pathogen E. coli and Enterococcus faecalis (48 and 28% respectively). The death rate was 12%. The average severity index was 5.64.


CONCLUSIONS
In our hospital, Fournier's gangrene is rare. Nevertheless, there is a rapid diagnosis protocol and therapeutic management is performed immediately. Until now, the immediate surgical treatment and early initiation of antibiotic therapy remains the best therapeutic option.


CONCLUSIONS
There is a relationship between the index of severity and patient survival, which may become a useful parameter in evaluating these patients.
Morua
Alejandro García
AG
Department of Urology, Hospital Universitario Dr. José Eleuterio González, Monterrey, Nuevo Leon, Mexico. agmorua@hotmail.com
Lopez
Juan Antonio Acuña
JA
Garcia
Jesus Domingo Gutierrez
JD
Montelongo
Rafael Martinez
RM
Guerra
Lauro Salvador Gomez
LS
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005260:Female; D018934:Fournier Gangrene / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013997:Time Factors; D055815:Young Adult