title: A case of Fournier's gangrene after liver transplantation: treated by hyperbaric oxygen therapy.
abstract: Fournier's gangrene (FG) is known as a rapidly progressing necrotizing fasciitis arising from genitourinary and colorectal infections. Misdiagnoses have occurred often because the initial presentation varies and is unclear. We report a case of FG in a 59-year-old man who had undergone a living donor liver transplant. He was in the maintenance phase of immunosuppressant treatment. FG occurred rapidly without symptoms and required prompt and aggressive debridement. Computed tomography demonstrated a small air density in his left testis. Treatment with hyperbaric oxygen therapy followed by intra- operative Gram's staining navigated debridement was additionally performed with general systematic anti-biological therapy and successfully cured the patient. Extra caution should be paid to patients who are maintained on immunosuppressants. Earlier detection and intervention will reduce the rate of mortality to a minimum.
authors.affiliation: Department of Digestive Surgery, Nihon University School of Medicine, Tokyo, Japan.
authors.forename: Nao
authors.initials: N
authors.lastname: Yoshida
authors.forename: Shintaro
authors.initials: S
authors.lastname: Yamazaki
authors.forename: Tadatoshi
authors.initials: T
authors.lastname: Takayama
mesh_terms: D018934:Fournier Gangrene / Q000209:etiology* / Q000628:therapy*; D006801:Humans; D006931:Hyperbaric Oxygenation; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010343:Patient Admission; D010388:Pelvis / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed