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Fournier’s Gangrene: A Review of Fournier’s Gangrene Severity Index (FGSI) and Other Predictors of Mortality

Open Journal of Urology 2024年第7期14卷 391-399页

作者： Makama Baje Salihu haruna liman Stephen Yusuf Aminu Umar Abraham Tunde Oladimeji Aremu Abdulrazak Urology Unit Department of Surgery Abubakar Tafawa Balewa University Teaching Hospital Bauchi Nigeria

Background: Fournier gangrene is an acute and rapidly progressive necrotizing fasciitis of the scrotum, perianal and perineal region of the body. It is a polymicrobial infection having an interplay of both anaerobic and aerobic orgasms in a soup of microbial disaster. Fournier’s gangrene was also initially thought to be an idiopathic condition but a lot of risk factors have been associated now with this condition, both systemic risk factors and local. Systemic risk factors include diabetes mellitus, HIV/AIDS, cancers, chronic liver disease, chronic steroid use etc. The local risk factors include perineal injuries, watering can perineum, perianal abscess, chronic perineal itching etc. Purpose: The swiftly flourishing bacteria orgasms cause a similar disruptive event in the body of the patients both clinically and biochemically and these can be used to create a predictive score or index for patients in order to assess the disease severity and guide in the management and prognostication of this condition. Materials and Method: Urology ward record books, clinic record books and operating theater records were used to identify patients managed for Fournier gangrene in ATBUTH Bauchi. A retrospective study of the medical files of all the patients managed from January 2011 to January 2024 was done. Folders were retrieved and the medical records were reviewed. Results: Of the 50 patients reviewed, Male to female ratio is 24:1. The mean age is 56 years (2 weeks to 97 years). Mortality rate was 34%. There is a significant difference between delayed presentation/initial use of unorthodox treatment with mortality (p = 0.002). Of the 17 patients that died, 15 had FGSI > 9 and of the 33 patients that survived 29 had FGSI 9 is 88.2% while the mortality rate for those with FGSI Conclusion: knowledge of the predictors of its mortality is necessary in other to help stratify patients and ensure the best response by the caregivers. FGSI, delayed presentation/initial patronage of unorthod

关键词： Fournier’s Gangrene FGSI Risk Factors Mortality

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Fournier’s Gangrene: 13-Year Experience in a Tertiary Center, North Eastern Nigeria

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Open Journal of Urology 2024年第7期14卷 407-414页

作者： Makama Baje Salihu haruna liman Stephen Yusuf Aminu Umar Oladimeji Abraham Tunde Ayodele Olufikayo Oshagbemi Amur Ibrahim Urology Unit Department of Surgery Abubakar Tafawa Balewa University Teaching Hospital Bauchi Nigeria

Background: Fournier’s gangrene is a fulminant infection of the genitourinary tract characterized by progressive necrosis of the skin and subcutaneous tissue of the external genitalia. Initially mainly seen involving the scrotum of elderly men with different moods of occurrence each unpleasantly lethal. With varying types of presentation only one thing has remained constant;the poor prognosis of this condition. Purpose/Aim: Thus, it’s important to study the trends of the presentation of this condition laying emphasis on the challenges in the management of these patients;both the negative and positive prognostic factors. Materials and Methods: Urology ward record books, clinic record books and operating theater records were used to identify patients managed for Fournier gangrene in ATBUTH Bauchi. A retrospective study of the medical files of all the patients managed from January 2011 to January 2024 was done. Data was analyzed using SPSS version 29. Results: Data from 47 patients seen during the period of study were carefully collected and analyzed. The age range is 2 weeks to 97 years. There were two neonates, one at 2nd week of life and the other at 3rd week. Mortality rate is 36%. The average time duration before presentation for patients that died was two weeks, a minimum of 9 days prior to presentation and a maximum of 21 days, about 10 of which came in septic shock and the remaining presented with fever and very extensive necrotizing fasciitis of the perineum. All the patients that died had diabetes mellitus as a comorbidity except the neonate. All the patients that survived were much younger, all were below 60 years of age (2 weeks - 53 years). Conclusion: Here, we share our experience managing patients with Fournier’s gangrene in our facility in the past 13-year period from January 2011 to January 2024. .

关键词： Fournier’s Gangrene Prognosis Elderly Presentation Treatment

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