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Research Articles Supplement 2 · 2018 · pp. 24–36 · Issue page

NECROTIZING FASCIITIS OF THE MALE GENITAL REGION – A REVIEW OF THE LITERATURE

LU
Lucian IORGA1
RA
Radu ANGHEL2
MA
Maria MANEA3
DR
Dragoş MARCU4
BO
Bogdan SOCEA5
CA
Camelia DIACONU6
OV
Ovidiu BRATU7
VL
Vlad-Dumitru BĂLEANU8
DA
Dan MISCHIANU9
1 Carol Davila University Emergency Central Emergency Military Hospital, 88 Mircea Vulcanescu Str, 010825, Bucharest, Romania
2 Carol Davila University Emergency Central Emergency Military Hospital, 88 Mircea Vulcanescu Str, 010825, Bucharest, Romania
3 Carol Davila University Emergency Central Emergency Military Hospital, 88 Mircea Vulcanescu Str, 010825, Bucharest, Romania
4 Carol Davila University Emergency Central Emergency Military Hospital, 88 Mircea Vulcanescu Str, 010825, Bucharest, Romania; University of Medicine and Pharmacy Carol Davila, 8 Eroii Sanitari Str, 050474, Bucharest, Romania
5 University of Medicine and Pharmacy Carol Davila, 8 Eroii Sanitari Str, 050474, Bucharest, Romania; "Sf. Pantelimon" Emergency Clinical Hospital, General Surgery Department, 340 Sos. Pantelimon, 021659, Bucharest, Romania
6 University of Medicine and Pharmacy Carol Davila, 8 Eroii Sanitari Str, 050474, Bucharest, Romania; Emergency Clinical Hospital of Bucharest, Internal Medicine Department, 8 Calea Floreasca, 014461, Bucharest, Romania
7 Carol Davila University Emergency Central Emergency Military Hospital, 88 Mircea Vulcanescu Str, 010825, Bucharest, Romania; University of Medicine and Pharmacy Carol Davila, 8 Eroii Sanitari Str, 050474, Bucharest, Romania; Academy of Romanian Scientists, 54 Splaiul Independentei, 050085, Bucharest, Romania
8 "Sf. Pantelimon" Emergency Clinical Hospital, General Surgery Department, 340 Sos. Pantelimon, 021659, Bucharest, Romania; University of Medicine and Pharmacy of Craiova, 2 Petru Rares Str., 200349, Craiova, Romania
9 Carol Davila University Emergency Central Emergency Military Hospital, 88 Mircea Vulcanescu Str, 010825, Bucharest, Romania; University of Medicine and Pharmacy Carol Davila, 8 Eroii Sanitari Str, 050474, Bucharest, Romania; Academy of Romanian Scientists, 54 Splaiul Independentei, 050085, Bucharest, Romania
Accepted 28 March 2026
Available Online 15 September 2018
Abstract
FOURNIER’S GANGRENE (FG) IS AN ACUTE AND RARE, RAPIDLY PROGRESSIVE AND LIFE-THREATENING FASCIITIS OF THE PERINEAL, GENITAL AND PERIANAL REGION WHICH CAN SPREAD TO THE ABDOMINAL WALL AND THIGHS WHICH COMMONLY AFFECTS MEN OVER 50 YEARS OLD. THE MOST FREQUENT RISK FACTORS INVOLVED IN FG PATHOGENESIS ARE: DIABETES MELLITUS (20 -70%) AND CHRONIC ETHANOL ABUSE (25-50%). PRIMUM MOVENS OF THIS DISEASE IS THE TRAUMA (ACCIDENTAL OR IATROGENIC) TO THE ANORECTAL AREA, UROGENITAL APPARATUS OR THE PERINEAL AND GENITAL SKIN. DESPITE ADVANCED MANAGEMENT MORTALITY IS STILL HIGH AND AVERAGES 20 –30%, THUS EARLY DIAGNOSIS REMAINS IMPERATIVE AS RAPID PROGRESSION CAN LEAD TO SEPS IS AND MULTIORGAN SYSTEM FAILURE. THE DIAGNOSIS IS MAD E MAINLY CLINICAL, BUT IMAGING STUDIES CAN BE HELPFUL TO DESCRIBE THE EXTENT OF THE DISEASE AND SHOULD, UNDER NO CIRCUMSTANCES, DELAY THE SURGICAL DEBRIDEMENT. THE LABORATORY RISK INDICATOR FOR NECROTIZING FASCIITIS SCORE CAN BE USED TO STRATIFY PATIENTS I NTO LOW, INTERMIDIATE AND HIGH RISK FOR DEVELOPING FG AND THE FOURNIER’S GANGRENE SEVERITY INDEX CAN BE USED TO DETERMINE THE MORTALITY RATE. THE GOLD-STANDARD TREATMENT IMPLIES EXTENSIVE SURGICAL DEBRIDEMENT AND BROAD SPECTRUM ANTIBIOTIC THERAPY ASSOCIATE D WITH VITAL FUNCTION SUPPORT THERAPY. THESE PATIENTS ARE OFTEN BEST APPROACHED IN A MULTIDISCIPLINARY TEAM, DUE TO THE FACT THAT THEY MAY NEED RECONSTRUCTIVE PROCEDURES IN THE FUTURE. THIS REVIEW AIMS TO BRING THIS FULMINATING DISEASE WITH A DEVASTATING IMPACT ON PATIENT’S LIFE INTO THE LIGHT AND TO UNDERLINE THE IMPORTANCE OF ITS PROMPT MANAGEMENT. FOR THIS
Keywords
FOURNIER’S GANGRENE NECROTIZING FASCII TIS SURGICAL DEBRIDEMENT
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