| 词条 | Fournier gangrene |
| 释义 |
| name = Fournier gangrene | synonyms = | image = File:Furnijerova_gangrena.jpg | caption = | pronounce = | field = Infectious disease | symptoms = | complications = | onset = | duration = | types = | causes = | risks = | diagnosis = | differential = | prevention = | treatment = | medication = | prognosis = | frequency = 1 per 62,500 males a year[1] | deaths = }} Fournier gangrene is a type of necrotizing fasciitis or gangrene affecting the external genitalia and/or perineum. It commonly occurs in older men, but it can also occur in women and children. It is more likely to occur in diabetics, alcoholics, or those who are immunocompromised. About one per 62,500 males are affected per year.[1] Males are affected about 40 times more often than females.[1] It was first described by Baurienne in 1764 and is named after a French venereologist, Jean Alfred Fournier, following five cases he presented in clinical lectures in 1883.[2] Signs and symptomsInitial symptoms of Fournier gangrene include swelling or sudden pain in the scrotum, fever, pallor, and generalized weakness.[2] More marked cases are characterized by a foul odor and purulent discharge from the infected tissue. Crepitus has been reported.[2] It begins as a subcutaneous infection. However, necrotic patches soon appear in the overlying skin, which later develop into necrosis.[2] CauseMost cases of Fournier gangrene are infected by both aerobic and anaerobic bacteria.[3] Resulting mortality increases in individuals lacking access not only to pragmatic resources such as sanitation and medical care, but to psychosocial resources, as well.[4] A 2006 Turkish study reported 46% of those diagnosed with Fourniers had elevated blood sugar levels.[5] Some additional findings seemingly link Fourniers with immunosuppression and alcoholism. One study reported about one-third of those diagnosed with Fournier had alcoholism with resulting diabetes and malnutrition, while another 10% had been medical immunosuppressed via chemotherapy, steroids, or malignancy.[6] DiagnosisFournier gangrene is usually diagnosed clinically, but laboratory tests and imaging studies are used to confirm diagnosis, determine severity, and predict outcomes.[2] X-rays and ultrasounds may show the presence of gas below the surface of the skin.[2] A CT scan can be useful in determining the site of origin and extent of spread.[2] TreatmentFournier gangrene is a urological emergency requiring intravenous antibiotics and debridement (surgical removal) of necrotic (dead) tissue.[2] In addition to surgery and antibiotics, hyperbaric oxygen therapy may be useful and acts to inhibit the growth of and kill the anaerobic bacteria.[7] PrognosisWhile recent case series (n=9–80) studies have found a mortality rate of 20–40%, a large (n=1641) 2009 study reported a mortality rate of 7.5%.[18] EpidemiologyA 2009 epidemiological study found the incidence of Fournier gangrene to be 1.6 cases per 100,000 males, in the United States.[8] Males 50 to 79 years old had the highest rate at 3.3 per 100,000.[8] Of 1,680 cases identified in the study, 39 were women.[8] Notable casesThe most historically prominent sufferers from this condition may have been Herod the Great, his grandson Herod Agrippa, and possibly the Roman emperor Galerius. Puerto Rican abolitionist and pro-independence leader Segundo Ruiz Belvis died from Fournier gangrene in November 1867.{{citation needed|date=November 2015}} References1. ^1 2 {{cite book|last1=Hamdy|first1=Freddie C.|last2=Eardley|first2=Ian|title=Oxford Textbook of Urological Surgery|date=2017|publisher=Oxford University Press|isbn=9780191022524|page=76|url=https://books.google.ca/books?id=qpc4DwAAQBAJ&pg=PA76|language=en}} 2. ^1 2 3 4 5 6 7 {{cite journal |first1= MN |last1= Mallikarjuna |first2= A |last2= Vijayakumar |first3= VS |last3= Patil |first4= BS |last4= Shivswamy |display-authors= 2 |date= 2012 |title= Fournier's gangrene: Current practices |journal= ISRN Surgery |volume= 2012 |pmc= 3518952 |doi= 10.5402/2012/942437 |pmid= 23251819 |page= 942437 |nopp= yes}} 3. ^{{cite journal |last1= Thwaini |first1= A |last2= Khan |first2= A |last3= Malik |first3= A |last4= Cherian |first4= J |last5= Barua |first5= J |last6= Shergill |first6= I |last7= Mammen |first7= K |display-authors= 2 |title=Fournier's gangrene and its emergency management |journal=Postgrad Med J |volume=82 |issue=970 |pages=516–9 |year=2006 |pmid=16891442 |doi=10.1136/pgmj.2005.042069 |pmc=2585703}} 4. ^{{cite journal|title=Non-Traumatic Urologic Emergencies in Men: A Clinical Review | pmc=2791735 | pmid=20046251 | volume=10 | issue=4 | date=November 2009 |last1= Kessler |first1= CS |last2= Bauml |first2= J | journal=West J Emerg Med | pages=281–7}} 5. ^1 {{cite journal |last1= Yanar |first1= H |last2= Taviloglu |first2= K |last3= Ertekin |first3= C |last4= Guloglu |first4= R |last5= Zorba |first5= U |last6= Cabioglu |first6= N |last7= Baspinar |first7= I |display-authors= 2 |title= Fournier's gangrene: Risk factors and strategies for management |journal= World J Surg |volume=30 |issue=9 |pages= 1750–4 |year=2006 |pmid=16927060 |doi=10.1007/s00268-005-0777-3}} 6. ^{{cite journal |last1= Tahmaz |first1= L |last2= Erdemir |first2= F |last3= Kibar |first3= Y |last4= Cosar |first4= A |last5= Yalcýn |first5= O |display-authors= 2 |title=Fournier's gangrene: Report of thirty-three cases and a review of the literature |journal=Int J Urol |volume=13 |issue=7 |pages=960–7 |year=2006 |pmid=16882063 |doi=10.1111/j.1442-2042.2006.01448.x}} 7. ^{{cite journal |last1= Zamboni |first1= WA |last2= Riseman |first2= JA |last3= Kucan |first3= JO |title= Management of Fournier's gangrene and the role of hyperbaric oxygen |journal= J. Hyperbaric Med |volume=5 |issue=3 |pages=177–86 |year= 1990 |url=http://archive.rubicon-foundation.org/4431 |accessdate=2008-05-16}} 8. ^1 2 3 {{cite journal |first1= MD |last1= Sorensen |first2= JN |last2= Krieger |first3= FP |last3= Rivara |first4= JA |last4= Broghammer |first5= MB |last5= Klein |first6= CD |last6= Mack |first7= H |last7= Wessells |display-authors= 2 |date= 2009 |title= Fournier's gangrene: Population based epidemiology and outcomes |journal= The Journal of Urology |volume= 181 |issue= 5 |pages= 2120–6 |pmid= 19286224 |pmc= 3042351 |doi= 10.1016/j.juro.2009.01.034}} 9. ^{{cite journal |vauthors=Burch DM, Barreiro TJ, Vanek VW |title=Fournier's gangrene: be alert for this medical emergency |journal=JAAPA |volume=20 |issue=11 |pages=44–7 |date=November 2007 |pmid=18035764 |doi=10.1097/01720610-200711000-00020 |url=http://media.haymarketmedia.com/Documents/2/fournier1107_1568.pdf |deadurl=yes |archiveurl=https://web.archive.org/web/20091007042739/http://media.haymarketmedia.com/Documents/2/fournier1107_1568.pdf |archivedate=2009-10-07 |df= }} 10. ^{{cite journal |author=Vaz I |title=Fournier gangrene |journal=Trop Doct |volume=36 |issue=4 |pages=203–4 |year=2006 |pmid=17034687 |doi=10.1258/004947506778604724}} 11. ^{{ cite journal |author=Eke N. |title=Fournier's gangrene: a review of 1726 cases |journal=British Journal of Surgery |volume=87 | issue=6 |pages=718–728 |year=2000 |doi=10.1046/j.1365-2168.2000.01497.x}} 12. ^{{cite journal |last=Herzog |first=W |title= Fournier gangrene--also in females? |journal=Zentralbl Chir |volume=112 |issue=9 |pages=564–76 |year=1987 |pmid=2956804}} External links{{Medical resources| DiseasesDB = 31119 | ICD10 = {{ICD10|N|49|8|n|40}} (ILDS N49.81), {{ICD10|N|76|8|n|70}} | ICD9 = {{ICD9|608.83}} | OMIM = | MedlinePlus = | GeneReviewsName = | ICDO = | eMedicineSubj = emerg | eMedicineTopic = 929 | eMedicine_mult = {{eMedicine2|med|2814}} | MeshID = D018934 }}
3 : Gangrene|Urological conditions|Bacterium-related cutaneous conditions |
| 随便看 |
|
开放百科全书收录14589846条英语、德语、日语等多语种百科知识，基本涵盖了大多数领域的百科知识，是一部内容自由、开放的电子版国际百科全书。