title: Fournier's gangrene: our experience with 50 patients and analysis of factors affecting mortality.
abstract: BACKGROUND
  Fournier's gangrene is a rare, rapidly progressive, necrotizing fasciitis of the external genitalia and perineum. Case series have shown a mortality rate of 20% to 40% with an incidence of as high as 88% in some reports. In this study we aimed to share our experience in the management of Fournier's gangrene and to identify risk factors that affect mortality.
  
  
  METHODS
  The medical records of 50 patients with Fournier's gangrene who presented at the University Hospital Hassan II of Fez from January 2003 to December 2009 were reviewed retrospectively to analyze the outcome and identify the risk factors and prognostic indicators of mortality.
  
  
  RESULTS
  Ten males and five females were enrolled in the study. The mean age was 54 years (range 23-81). The most common predisposing factor was diabetes mellitus (34%). E. coli was the most frequent bacterial organisms cultured. All patients were treated with a common approach of resuscitation, broad-spectrum antibiotics, and wide surgical excision. The mortality rate was 24%. The advanced age, renal failure on admission, extension of infection to the abdominal wall, occurrence of septic shock and need for postoperative mechanical ventilation are the main prognostic factors of mortality. In multivariate analysis, none of these variables is an independent predictor of mortality.
  
  
  CONCLUSIONS
  Fournier's gangrene is still a very severe disease with high mortality rates. Early recognition of infection associated with invasive and aggressive treatment is essential for attempting to reduce these prognostic indices.
authors.affiliation: Department of surgery, University hospital Hassan II, Fez, Morocco. benjelloun19@hotmail.com.
authors.forename: El Bachir
authors.initials: el B
authors.lastname: Benjelloun
authors.forename: Tarik
authors.initials: T
authors.lastname: Souiki
authors.forename: Nadia
authors.initials: N
authors.lastname: Yakla
authors.forename: Abdelmalek
authors.initials: A
authors.lastname: Ousadden
authors.forename: Khalid
authors.initials: K
authors.lastname: Mazaz
authors.forename: Abdellatif
authors.initials: A
authors.lastname: Louchi
authors.forename: Nabil
authors.initials: N
authors.lastname: Kanjaa
authors.forename: Khalid Ait
authors.initials: KA
authors.lastname: Taleb
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