Fournier's gangrene Flashcards
What is Fourniers gangrene?
necrotising fasciitis that affects the perineum
What is necrotising fasciitis?
rapidly spreading necrosis of subcutaneous tissue and fascia
What kind of infections can Fourniers gangrene be?
monomicrobial or polymicrobial infection with causative organisms including group A streptococcus, C perfringes and E coli
What are the anatomic barriers to Fourniers gangrene?
Dartos fascia of the penis and scrtum, collet fascia of the perineum and scrapa fascia of the anterior abdominal wall so the testes and epididymis are not usually affected
What are the risk factors for Fourniers gangrene?
Diabetes mellitus, excess alcohol, poor nutritional state, steroids, haematological malignancies, recent trauma to the region
What are the clinical features of Fourniers gangrene?
Severe pain, pyrexia, non specific usually, credits, skin necrosis, haemorrhage bullae, rapidly deteriorate
What is the differential diagnosis for Fourniers gangrene?
cellulitis, testicular torsion and epididmyo-orchitis
How would you diagnose Fourniers gangrene?
mainly clinically but would do a blood test, blood cultures, CT would show fascial swellings but is less specific
What does LRINEC stand for?
Laboratory risk indicator for necrotising fasciitis
What LRINEC score means diagnosis of necrotising fasciitis on lab results alone?
6 or greater
What is the management for Fourniers gangrene?
Urgent surgical debridement, partial or total orchiectomy, broad spectrum antibiotics and put in high dependancy setting, fluids, second surgical debridement and usually skin grafts are needed
What levels are measured in the LRINEC?
CRP, white cell count, haemoglobin, serum sodium, creatinine and glucose
