Case Report
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Coexistence of Human Immuno deficiency Virus ,Diabetes Mellitus, Epididymal Cysts , and Fournier's Gangrene: A Case Report

Year 2021, Volume: 38 Issue: 4, 669 - 671, 09.10.2021

Abstract

Fournier's gangrene (FG) is a form of necrotizing fasciitis that is localized in the external genital organs and perianal region and causes skin and subcutaneous tissue gangrene. The clinical picture may vary depending on the patient's comorbidities and the extent of infection; Many predisposing conditions such as immunodeficiency, diabetes, alcoholism encourage the spread of the infection. In this case report, we highlighted the importance of emergency debridement in patients with multiple comorbidities by presenting the Fournier's Gangrene case in a 57-year-old immunosuppressive male patient with cystic lesions in the epididymis, with a history of hypertension, coronary artery disease, diabetes, HIV (human immunodeficiency virus) and a history of bipolar disorder. The patient, who was operated on for debridement by the urology, was given 1x500mg daptomycin, 3x1g meropenem, 3x450mg clindamycin IV treatment. The patient was discharged with full recovery after 17 days of hospitalization.
Clinical suspicion in Fournier's gangrene cases, early surgical debridement, and broad-spectrum anti biotherapy are important. with rapid diagnosis and treatment in patients with improvement can also be seen in patients with comorbidities.

References

  • Basoglu M, Ozbey I, Atamanalp S.S, Yildirgan M.I, Aydinli B, PolatO, Ozturk G, Peker K, Onbas O, & Oren D. 2007. Management of Fournier’s gangrene: Review of 45 cases. Surgery Today, 37(7), 558–563. https://doi.org/10.1007/s00595-006-3391-6
  • Carroll P R, Cattolica E. V, Furzan K. W. 1986. Necrotisingsofttis- sueinfection of theperineumandgenitalia :aetiologyandearlyreconstruction. West J Med, 144 :174-8.
  • Chernyadyev S. A, Ufimtseva M A., Vishnevskaya I. F, Bochkarev Y. M, Ushakov A. A, Beresneva T. A, Galimzyanov F. V, & Khodakov V. V. 2018. Fournier’s Gangrene: Literature Review and Clinical Cases. Urologia Internationalis, 101(1), 91–97. https://doi.org/10.1159/000490108.
  • Cook BP, Verdone C, Ricchiuti D. 2020. Scrotal emphysema with characteristics of Fournier's gangrene in a community setting. Urology Casr Reports, 33:101345. https://doi.org/10.1016/j.eucr.2020.101345.
  • Elem B, Ranjan P. 1995. Impact of immunodeficiencyvirus (HIV) on Fournier'sgangrene: observations in Zambia. Ann R CollSurgEngl. Jul; 77(4): 283-6.
  • El-Qushayri A. E, Khalaf K. M, Dahy A, Mahmoud A. R, Benmelouka A. Y, Ghozy S, Mahmoud M. U, Bin-Jumah M, Alkahtani S, & Abdel-Daim M. M. 2020. Fournier’s gangrene mortality: A 17-year systematic review and meta-analysis. International Journal of Infectious Diseases, 92, 218–225. https://doi.org/10.1016/j.ijid.2019.12.030.
  • İslam M. M, & Aksel G. 2019. Diyabetus Mellitus ve Fournier Gangreni Birlikteliği: Olgu Sunumu. 2(1), 30–33. Mardi K. 2014. Multiplescrotalepidermalcysts: A rarecasereport. J ClinSci 11:20-1.
  • Ngugi P, Magoha G, Nyaga P. 2014. Fournier'sgangrene in the HIV era. Africanhealthsciences. 14(4):1063- 8.
  • Radcliffe R. S, & Khan M. A. 2020. Mortality associated with Fournier’s gangrene remains unchanged over 25 years. BJU International, 125(4), 610–616. https://doi.org/10.1111/bju.14998.
  • Smith GL, Bunker CB, Dinneen MD. 1998. Fournier's gangrene. Br J Urol. 81(3): 347-55. PubMed
  • Sockkalingam, V S, Subburayan E, Velu E, Rajashekar S. T, & Swamy A. M. 2018. Fournier’s gangrene: Prospective study of 34 patients in South Indian population and treatment strategies. Pan African Medical Journal, 31, 1–8. https://doi.org/10.11604/pamj.2018.31.110.15495.
  • Taylor G. M, & Hess D. V. 2018. Fournier gangrene: A rare case of necrotizing fasciitis of the entire right hemi-pelvis in a diabetic female. Oxford Medical Case Reports, 48–49. https://doi.org/10.1093/omcr/omx094.
  • Unalp HR, Kamer E3, Derici H, Atahan K, Balcı U, Demirdöven C, Nazlı O, Onal MA. 2008. Fournier's gangrene: Evaluation of 68 patients and analysis of prognostic variables. J Postgrad Med. 54(2):102-5.
  • Yoshino Y, Funahashi K, Okada R, Miura Y, Suzuki T, Koda T, Yoshida K, Koike J, Shiokawa H, Ushigome M, Kaneko T, Nagashima Y, Goto M, Kurihara A, & Kaneko H. 2016. Severe Fournier’s gangrene in a patient with rectal cancer: Case report and literature review. World Journal of Surgical Oncology, 14(1), 1–5. https://doi.org/10.1186/s12957-016-0989-z.
  • Zhang N, Yu X, Zhang K, & Liu T. 2020. A retrospective case series of Fournier’s gangrene: necrotizing fasciitis in perineum and perianal region. BMC Surgery, 20(1), 1-8. https://doi.org/10.1186/s12893-020-00916-3.
Year 2021, Volume: 38 Issue: 4, 669 - 671, 09.10.2021

Abstract

References

  • Basoglu M, Ozbey I, Atamanalp S.S, Yildirgan M.I, Aydinli B, PolatO, Ozturk G, Peker K, Onbas O, & Oren D. 2007. Management of Fournier’s gangrene: Review of 45 cases. Surgery Today, 37(7), 558–563. https://doi.org/10.1007/s00595-006-3391-6
  • Carroll P R, Cattolica E. V, Furzan K. W. 1986. Necrotisingsofttis- sueinfection of theperineumandgenitalia :aetiologyandearlyreconstruction. West J Med, 144 :174-8.
  • Chernyadyev S. A, Ufimtseva M A., Vishnevskaya I. F, Bochkarev Y. M, Ushakov A. A, Beresneva T. A, Galimzyanov F. V, & Khodakov V. V. 2018. Fournier’s Gangrene: Literature Review and Clinical Cases. Urologia Internationalis, 101(1), 91–97. https://doi.org/10.1159/000490108.
  • Cook BP, Verdone C, Ricchiuti D. 2020. Scrotal emphysema with characteristics of Fournier's gangrene in a community setting. Urology Casr Reports, 33:101345. https://doi.org/10.1016/j.eucr.2020.101345.
  • Elem B, Ranjan P. 1995. Impact of immunodeficiencyvirus (HIV) on Fournier'sgangrene: observations in Zambia. Ann R CollSurgEngl. Jul; 77(4): 283-6.
  • El-Qushayri A. E, Khalaf K. M, Dahy A, Mahmoud A. R, Benmelouka A. Y, Ghozy S, Mahmoud M. U, Bin-Jumah M, Alkahtani S, & Abdel-Daim M. M. 2020. Fournier’s gangrene mortality: A 17-year systematic review and meta-analysis. International Journal of Infectious Diseases, 92, 218–225. https://doi.org/10.1016/j.ijid.2019.12.030.
  • İslam M. M, & Aksel G. 2019. Diyabetus Mellitus ve Fournier Gangreni Birlikteliği: Olgu Sunumu. 2(1), 30–33. Mardi K. 2014. Multiplescrotalepidermalcysts: A rarecasereport. J ClinSci 11:20-1.
  • Ngugi P, Magoha G, Nyaga P. 2014. Fournier'sgangrene in the HIV era. Africanhealthsciences. 14(4):1063- 8.
  • Radcliffe R. S, & Khan M. A. 2020. Mortality associated with Fournier’s gangrene remains unchanged over 25 years. BJU International, 125(4), 610–616. https://doi.org/10.1111/bju.14998.
  • Smith GL, Bunker CB, Dinneen MD. 1998. Fournier's gangrene. Br J Urol. 81(3): 347-55. PubMed
  • Sockkalingam, V S, Subburayan E, Velu E, Rajashekar S. T, & Swamy A. M. 2018. Fournier’s gangrene: Prospective study of 34 patients in South Indian population and treatment strategies. Pan African Medical Journal, 31, 1–8. https://doi.org/10.11604/pamj.2018.31.110.15495.
  • Taylor G. M, & Hess D. V. 2018. Fournier gangrene: A rare case of necrotizing fasciitis of the entire right hemi-pelvis in a diabetic female. Oxford Medical Case Reports, 48–49. https://doi.org/10.1093/omcr/omx094.
  • Unalp HR, Kamer E3, Derici H, Atahan K, Balcı U, Demirdöven C, Nazlı O, Onal MA. 2008. Fournier's gangrene: Evaluation of 68 patients and analysis of prognostic variables. J Postgrad Med. 54(2):102-5.
  • Yoshino Y, Funahashi K, Okada R, Miura Y, Suzuki T, Koda T, Yoshida K, Koike J, Shiokawa H, Ushigome M, Kaneko T, Nagashima Y, Goto M, Kurihara A, & Kaneko H. 2016. Severe Fournier’s gangrene in a patient with rectal cancer: Case report and literature review. World Journal of Surgical Oncology, 14(1), 1–5. https://doi.org/10.1186/s12957-016-0989-z.
  • Zhang N, Yu X, Zhang K, & Liu T. 2020. A retrospective case series of Fournier’s gangrene: necrotizing fasciitis in perineum and perianal region. BMC Surgery, 20(1), 1-8. https://doi.org/10.1186/s12893-020-00916-3.
There are 15 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Case Report
Authors

Evrim Kar 0000-0003-3063-6635

Hatice Şeyma Akça 0000-0003-2823-9577

Serdar Özdemir 0000-0002-6186-6110

Abdullah Algın 0000-0002-9016-9701

Serkan Emre Eroğlu 0000-0002-3183-3713

Publication Date October 9, 2021
Submission Date February 12, 2021
Acceptance Date February 17, 2021
Published in Issue Year 2021 Volume: 38 Issue: 4

Cite

APA Kar, E., Akça, H. Ş., Özdemir, S., Algın, A., et al. (2021). Coexistence of Human Immuno deficiency Virus ,Diabetes Mellitus, Epididymal Cysts , and Fournier’s Gangrene: A Case Report. Journal of Experimental and Clinical Medicine, 38(4), 669-671.
AMA Kar E, Akça HŞ, Özdemir S, Algın A, Eroğlu SE. Coexistence of Human Immuno deficiency Virus ,Diabetes Mellitus, Epididymal Cysts , and Fournier’s Gangrene: A Case Report. J. Exp. Clin. Med. October 2021;38(4):669-671.
Chicago Kar, Evrim, Hatice Şeyma Akça, Serdar Özdemir, Abdullah Algın, and Serkan Emre Eroğlu. “Coexistence of Human Immuno Deficiency Virus ,Diabetes Mellitus, Epididymal Cysts , and Fournier’s Gangrene: A Case Report”. Journal of Experimental and Clinical Medicine 38, no. 4 (October 2021): 669-71.
EndNote Kar E, Akça HŞ, Özdemir S, Algın A, Eroğlu SE (October 1, 2021) Coexistence of Human Immuno deficiency Virus ,Diabetes Mellitus, Epididymal Cysts , and Fournier’s Gangrene: A Case Report. Journal of Experimental and Clinical Medicine 38 4 669–671.
IEEE E. Kar, H. Ş. Akça, S. Özdemir, A. Algın, and S. E. Eroğlu, “Coexistence of Human Immuno deficiency Virus ,Diabetes Mellitus, Epididymal Cysts , and Fournier’s Gangrene: A Case Report”, J. Exp. Clin. Med., vol. 38, no. 4, pp. 669–671, 2021.
ISNAD Kar, Evrim et al. “Coexistence of Human Immuno Deficiency Virus ,Diabetes Mellitus, Epididymal Cysts , and Fournier’s Gangrene: A Case Report”. Journal of Experimental and Clinical Medicine 38/4 (October 2021), 669-671.
JAMA Kar E, Akça HŞ, Özdemir S, Algın A, Eroğlu SE. Coexistence of Human Immuno deficiency Virus ,Diabetes Mellitus, Epididymal Cysts , and Fournier’s Gangrene: A Case Report. J. Exp. Clin. Med. 2021;38:669–671.
MLA Kar, Evrim et al. “Coexistence of Human Immuno Deficiency Virus ,Diabetes Mellitus, Epididymal Cysts , and Fournier’s Gangrene: A Case Report”. Journal of Experimental and Clinical Medicine, vol. 38, no. 4, 2021, pp. 669-71.
Vancouver Kar E, Akça HŞ, Özdemir S, Algın A, Eroğlu SE. Coexistence of Human Immuno deficiency Virus ,Diabetes Mellitus, Epididymal Cysts , and Fournier’s Gangrene: A Case Report. J. Exp. Clin. Med. 2021;38(4):669-71.