Nature clinical practice. Urology · 2006
Fournier's gangrene.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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'Aho Tevita, Canal Alessandra, Neal David E
Аннотация
BACKGROUND: A 59-year-old man presented with a 4-day history of scrotal pain and swelling and the rapid development of moist, black, foul-smelling lesions on the scrotum and penis. As a liver-transplant recipient, he was immunosuppressed. He also had type 1 (insulin-dependent) diabetes and poor nutrition, which might have compromised immunity further.
INVESTIGATIONS: Physical examination, blood and tissue cultures, full blood count, urea and electrolytes, liver function tests, coagulation profile, C-reactive protein, and examination under anesthesia.
DIAGNOSIS: Fournier's gangrene originating from an infected cutaneous lesion in an immunocompromised patient.
MANAGEMENT: Resuscitation and triple broad-spectrum antibiotics, urgent surgical debridement, serial examinations under anesthesia with further debridements, and split-skin grafting. Phallic reconstruction is planned.
INVESTIGATIONS: Physical examination, blood and tissue cultures, full blood count, urea and electrolytes, liver function tests, coagulation profile, C-reactive protein, and examination under anesthesia.
DIAGNOSIS: Fournier's gangrene originating from an infected cutaneous lesion in an immunocompromised patient.
MANAGEMENT: Resuscitation and triple broad-spectrum antibiotics, urgent surgical debridement, serial examinations under anesthesia with further debridements, and split-skin grafting. Phallic reconstruction is planned.