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Original Articles
Anorectal benign disease
Fournier gangrene with concurrent multifocal necrotizing fasciitis: a systematic review and case report
Jessica A. Paynter, Kirby R. Qin, Dongrong Situ, Chun Hin Angus Lee
Ann Coloproctol. 2023;39(5):421-426.   Published online May 26, 2022
DOI: https://doi.org/10.3393/ac.2022.00192.0027
  • 3,563 View
  • 182 Download
  • 1 Web of Science
  • 2 Citations
AbstractAbstract PDF
Purpose
A patient presented to a regional surgical center with Fournier gangrene (FG) and concurrent multifocal necrotizing fasciitis (NF). Given the rarity, it was decided to undertake a systematic review to investigate the incidence and prevalence of FG with multifocal NF and consequently determine the treatment and approach to management of such presentation.
Methods
Firstly, the report of the 56-year-old male patient is discussed regarding his surgical management. Secondly, a systematic review was undertaken according to PRISMA guidelines using MEDLINE, Scopus, and Embase databases. Searches used the following MeSH terms: (“fournier’s gangrene”) AND ((necrotising fasciitis) OR (necrotising soft tissue infection)). Once the search results were obtained, duplicate articles were removed. Titles, abstracts, and articles were reviewed by 2 authors.
Results
The search strategy using the 3 databases revealed a total of 402 studies. Fifty-seven studies were removed due to duplication. A total of 345 records were screened via title and abstract, of which 115 were excluded. Two hundred and thirty studies were reviewed for eligibility. A total of all 230 studies were excluded; 169 were excluded as they included the incorrect patient population (patients suffered from FG or NF, but not both collectively), 60 studies were excluded due to incorrect study designs, and 1 report occurred in the wrong setting.
Conclusion
This highlights that while being a relatively known, uncommon infection both FG and NF are well documented separately within the literature. However, FG with concurrent multifocal NF has not been documented within the literature.

Citations

Citations to this article as recorded by  
  • FOURNIER'S GANGRENE: A CASE REPORT
    Serhiy Morozov, Mariia Matvieienko, Tetiana Kozlova
    Eastern Ukrainian Medical Journal.2024; 12(2): 448.     CrossRef
  • Fournier's gangrene complicated by lower limb necrotising fasciitis and pelvic bone osteomyelitis: A case report with literature review
    Joshua Chek Hao Foo, Ernest Junrui Lim, Alvin Yuanming Lee, Yadong Lu
    International Journal of Surgery Case Reports.2024; 121: 109974.     CrossRef
Anorectal benign disease
The role of C-reactive protein ratio in predicting mortality in patients with Fournier gangrene
Ismail Cem Eray, Kubilay Dalci, Serdar Gumus, Orcun Yalav, Ahmet Gokhan Saritas, Asli Boz, Ahmet Rencuzogullari
Ann Coloproctol. 2023;39(3):223-230.   Published online February 3, 2022
DOI: https://doi.org/10.3393/ac.2021.00843.0120
  • 3,165 View
  • 132 Download
  • 3 Web of Science
  • 4 Citations
AbstractAbstract PDF
Purpose
This study aimed to determine the C-reactive protein (CRP) ratio for the survival of patients with Fournier gangrene (FG).
Methods
Fifty-two patients with FG between January 2011 and September 2018 were retrospectively analyzed. Data on clinical presentation, Fournier Gangrene Severity Index (FGSI), CRP ratio, management, and outcome were analyzed. The CRP ratio was calculated as preoperative CRP/postoperative CRP value that measured 48 hours after surgical intervention. Possible alternative cutoff points for the FGSI and CRP were determined by receiver operating characteristic (ROC) analyses. The risk factors related to the prognosis were evaluated by univariate and multivariable logistic regression analyses.
Results
The mean CRP ratios were 6.7±6.6 in the survivor group and 1.2±0.8 in the nonsurvivor group (P=0.001). FGSI was significantly higher in the non-survivor group compared to survivor group (8.5±2.5 vs. 3.5±2.2, P=0.001). There was a negative correlation between FGSI and CRP ratio (r=–0.51). ROC analysis determined the cutoff value as 1.78 for CRP (sensitivity, 86%; specificity, 82%; area under the ROC curve, 0.90) to predict death. The incidence of death for patients with CRP ratio of ≤1.78 increased 26.7 fold for those with CRP ratio of >1.78 (95% confidence interval [CI], 4.8–146.5; P=0.001). In the multivariable logistic regression model, CRP ratio (odds ratio [OR], 10.3; 95% CI, 1.5–72.2; P=0.019) and FGSI (OR, 17.8; 95% CI, 2.6–121.1; P=0.003) were independent risk factors for death.
Conclusion
The CRP ratio is a simple method to use to predict mortality in FG.

Citations

Citations to this article as recorded by  
  • The Value of Fournier’s Gangrene Scoring Systems on Admission to Predict Mortality: A Systematic Review and Meta-Analysis
    Antonio Tufano, Piervito Dipinto, Francesco Passaro, Umberto Anceschi, Giorgio Franco, Rocco Simone Flammia, Flavia Proietti, Luca Antonelli, Giovanni Battista Di Pierro, Francesco Prata, Roberta Rullo, Sisto Perdonà, Costantino Leonardo
    Journal of Personalized Medicine.2023; 13(9): 1283.     CrossRef
  • Biomarkers to predict mortality in patients with Fournier’s gangrene admitted to the intensive care unit after surgery in South Korea
    In Sik Shin, Seong Chan Gong, Sanghyun An, Kwangmin Kim
    Acute and Critical Care.2023; 38(4): 452.     CrossRef
  • Fournier's gangrene. Literature review
    Débora Pattussi , Federico Carballo
    AG Salud.2023; 1: 83.     CrossRef
  • Delta neutrophil index as a prognostic factor for mortality in patients with Fournier's gangrene
    In Sik Shin, Seong Chan Gong, Sanghyun An, Kwangmin Kim
    International Journal of Urology.2022; 29(11): 1287.     CrossRef
Case Report
Benign proctology,Rare disease & stoma,Complication
Fournier Gangrene in a Patient With Type 2 Diabetes Mellitus Treated With Dapagliflozin: A Case Report
Jae Young Moon, Min Ro Lee, Jong Hun Kim, Gi Won Ha
Ann Coloproctol. 2021;37(Suppl 1):S48-S50.   Published online May 28, 2021
DOI: https://doi.org/10.3393/ac.2020.06.22
  • 3,725 View
  • 151 Download
  • 3 Web of Science
  • 5 Citations
AbstractAbstract PDF
Rare cases of Fournier gangrene (FG) possibly associated with sodium-glucose cotransporter 2 inhibitors have been reported. We present a case of a 66-year-old male patient with type 2 diabetes mellitus on oral metformin, glimepiride, and dapagliflozin therapy. He presented with pain in the perineum and scrotum for 5 days. The clinical finding, computed tomography finding, and laboratory data were matched with FG. Emergency surgical drainage, debridement of necrotic tissue, and diverting loop ileostomy formation were performed by a urologist and a surgeon. The patient had no complications from diabetes before the onset of FG, and serum glucose management was good at the onset of FG. This case shows an FG patient with good glucose management taking dapagliflozin and suggests a possible association between dapagliflozin and FG. Further evaluation and additional research on this relationship are needed.

Citations

Citations to this article as recorded by  
  • Fournier’s Gangrene as an Adverse Event Following Treatment with Sodium Glucose Cotransporter 2 Inhibitors
    Ioana-Maria Suciu, Alin Greluș, Alina-Ramona Cozlac, Bogdan-Simion Suciu, Svetlana Stoica, Silvia Luca, Constantin-Tudor Luca, Dan-Ion Gaiță
    Medicina.2024; 60(5): 837.     CrossRef
  • A Case of Fournier's Gangrene Following the Initiation of Dapagliflozin
    Natalie Shaykh, Avni Agrawal, Melville C O'Brien, Oshin Rai, Vanshika Tripathi, Vishal Jaikaransingh
    Cureus.2024;[Epub]     CrossRef
  • Skin-Related Adverse Reactions Induced by Oral Antidiabetic Drugs—A Review of Literature and Case Reports
    Justyna Kowalska, Dorota Wrześniok
    Pharmaceuticals.2024; 17(7): 847.     CrossRef
  • Management of Fournier’s gangrene during the Covid-19 pandemic era: make a virtue out of necessity
    Alessio Paladini, Giovanni Cochetti, Angelica Tancredi, Matteo Mearini, Andrea Vitale, Francesca Pastore, Paolo Mangione, Ettore Mearini
    Basic and Clinical Andrology.2022;[Epub]     CrossRef
  • Dapagliflozin

    Reactions Weekly.2022; 1926(1): 197.     CrossRef
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