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Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We reviewed the records of 17 cases of Fournier's gangrene that had been diagnosed and treated in the Urology Service of the Marques de Valdecilla Hospital from 1982-1991. The series comprised male patients aged 32 to 77. Eleven cases (64.7%) were due to a known cause, above all infection. Most of the patients had factors that predisposed to the development and progression of the disease, predominantly diabetes mellitus (5 cases, 29.4%). The clinical features frequently corresponded to those of acute infection, with high fever, chills, pain, nausea and vomiting that could progress to a septic state. The local symptoms and signs included pain, swelling, erythema and necrosis, depending on the compromised area. Infection was usually caused by Gram-negative bacteria, particularly E. coli, although Gram-positive bacteria and anaerobes have been observed. Mixed bacterial infections have also been observed. Treatment must be instituted early using a combination of broad spectrum antibiotics that cover both aerobes and anaerobes, and wide surgical debridement of the compromised area. In some cases hyperbaric oxygen therapy may be warranted. The disease continues to be severe. In the present series, the outcome was favorable in 12 cases (70.5%) and there were 5 deaths (29.4%).
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PMID:[Our caseload in Fournier's disease]. 129 42

Fournier's gangrene is an acute gangrenous inflammation of the male genitalia. In an 18-month period, four patients with Fournier's gangrene were treated at our hospital. Their ages ranged from 39 to 74 years (average 55.2). The presenting symptoms and signs included pain, swelling and necrosis of the scrotum and perineum, fever and jaundice were also noted. Three patients with the predisposing factor of urinary tract infection or perianal abscess recovered after surgical debridement and antibiotics treatment. Their hospital stay ranged between 13 and 50 days. One patient with diabetes, presenting severe septic shock at arrival, died one day after debridement. From the experience of our cases and review of the literature, early surgical debridement and antibiotics are mandatory for the treatment of Fournier's gangrene.
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PMID:Fournier's gangrene: experience of four cases. 165 28

We report a case of Fournier's gangrene affecting a 77-year-old man. The patient was found to have decompensated diabetes mellitus that had been ignored before the onset of the disease. Several authors have described earlier a dramatic, explosive disease, leading to severe prostration within a few hours. Most of the recent cases, like this patient, have had a more insidious course, with symptoms beginning several days before hospitalization. Forty-five days after surgical debridement under spinal anesthesia and daily local treatment the scrotum was completely healed. The etiology and pathogenesis of this infrequent disease are discussed.
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PMID:Fournier's disease. Report of a case and review of the literature. 179 51

Fournier's gangrene of the scrotum, a form of necrotising fasciitis, is a rare but potentially fatal disorder. Predisposing conditions include chronic alcoholism and diabetes mellitus, possibly as a result of impaired immunity. Fournier's syndrome, occurring in a patient with AIDS, is described.
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PMID:Fournier's gangrene of scrotum in a patient with AIDS. 191 98

Fournier's gangrene is defined classically as a fulminant, rapidly spreading infection of the scrotum that also involves the perineum, penis and abdominal wall. The pathologic findings are described as synergistic gangrene secondary to a polymicrobial flora with a poorly defined portal of entry. We report 3 cases of Fournier's gangrene. Case 1 was a 67 years old who was admitted with the chief complaint of scrotal swelling and necrosis. Case 2 was a 59 years old who was admitted with the problem of scrotal swelling and pain, he had sought other medical help without success, and was then transferred to our hospital. Case 3 was a 62 years old who was admitted with the chief complaint of scrotal swelling and pain for 2 days. These 3 patients were all found to have diabetes mellitus. All 3 patients required aggressive surgical debridement, broad-spectrum antibiotics and adjunctive measures. Blood cultures were usually negative and pus cultures were typically aerobic gram-negative rods and gram-positive cocci and anaerobic bacteria of various types, especially Bacteroids fragilis. Our pus cultures revealed Escherichia coli and Staphylococcus aureus in Case 1, Enterobacter cloacae in Case 2 and E. coli, B. fragilis and Pseudomonas aeruginosa in Case 3. This disease is no longer a disease of young men. After 1945, the average age in 119 reported cases was 51.3 years and the average age of our cases was 62.7 years. Before the era of antibiotics, scrotal gangrene was not a rarity. In these modern times, in spite of seeking medical attention early, patients still developed scrotal gangrene and the mortality rate is high.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Fournier's gangrene: report of 3 cases]. 198 85

Fournier's gangrene or synergistic gengrene of scrotum and penis is a relatively rare but serious condition which can occur in any general or hospital practice. Early diagnosis with prompt aggressive treatment including antibiotics and surgical debridement are necessary to achieve patient survival. We report our clinical experience with three cases which occurred in three different hospitals in the Irish Republic. In two of these cases diabetes mellitus was an important predisposing factor. All three patients underwent surgery as well as antibiotic treatment in spite of which one patient failed to survive.
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PMID:Fournier's gangrene. 204 67

We have experienced a case of Fournier's gangrene which progressed rapidly after prostatic massage. The patient was a 70-year-old man who had poorly controlled diabetes mellitus, hemorrhoid, urethral stricture and benign prostatic hyperplasia. He visited an urologist complaining of pollakisuria and miction pain. Under the diagnosis of prostatitis, prostatic massage was performed. From that night, he developed a high grade fever. Simultaneously, redness, swelling and pain of the scrotum progressed rapidly, and 11 days later, he was admitted to our hospital. An X-ray examination revealed subcutaneous gas formation in the scrotum. Immediately, incision and drainage with extensive debridement of necrotic tissue were performed combined with chemotherapy using broad spectrum antibiotics and insulin therapy. About 3 months later, the gangrene and the wound were healed with granulation and scarring. Cultures of the pus and the necrotic tissue from the scrotum were positive for Bacteroides fragilis and several aerobes including Staphylococcus aureus, Pseudomonas aeruginosa, Klebsiella pneumoniae, Enterococcus and Staphylococcus epidermidis. The case proved to be non-clostridial gas gangrene.
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PMID:[A case of Fournier's gangrene: was it triggered by prostatic massage?]. 223 20

Nine cases of Fournier's gangrene diagnosed between 1982 and 1989 are reported. All were males with a mean age of 76 (47-82 years). Seven had a history of alcoholism and one had non insulin-dependent diabetes. Six patients also had an anal fistula which may have been the starting point of the infection. The causal agents were two anaerobes (Clostridium perfringens and Bacteroides fragilis) two gram-negatives (Morganella morgagni and Pseudomonas aeruginosa) and one, an unidentified gram-positive. In three patients a mixed intestinal flora was isolated and in another no germs were found. All were treated with broad-spectrum antibiotics and surgery. Seven patients survived and two died.
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PMID:[Fournier's disease: a report of 9 cases]. 227 37

A case is described in which Fournier's gangrene was the presenting feature of diabetes mellitus and in which extensive subcutaneous emphysema prevented the use of spinal anaesthesia for debridement. In the literature four cases have been reported in which Fournier's gangrene was the presenting feature in patients with diabetic ketoacidosis. Diabetes may predispose to a form of Fournier's gangrene in which subcutaneous gas formation is marked, though subcutaneous emphysema to the degree described in this case has not previously been reported in this condition. Diabetes mellitus and subcutaneous emphysema must be sought in patients with Fournier's gangrene as both may have a profound influence on management.
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PMID:Diabetes mellitus and Fournier's gangrene. 295 Nov 85

A 59-year-old man was admitted to our hospital complaining of perineal pain and scrotal redness. He was diagnosed with diabetes mellitus 12-years ago but had not received treatment. The scrotum soon showed necrosis and pus discharge. A culture study revealed Clostridium, Bacteroides and many other bacteria. Antibiotics chemotherapy (CMZ, AMK, MINO) was done but because necrotizing fasciitis progressed, we performed surgical treatment of necrosis. The skin defect was closed naturally with wound irrigation. The patient is doing well and his diabetes is under control. We found 13 other cases of Fournier's gangrene in the Japanese literature and their age, culture study and complications are discussed.
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PMID:[A case of Fournier's gangrene]. 307 76


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