WORLD JOURNAL OF ADVANCE
HEALTHCARE RESEARCH

Dr. Shweta Kumari, Dr. (Prof) Vimal Mukesh*, Dr. Md Sarfaraz Alam, Dr. Pranay Kumar4 and Dr. Babar Ali

ABSTRACT

Objective: To determine the clinico-pathological features of Fournier’s gangrene and to identify risk factors associated with the mortality. Material and Methods: This retrospective study was done at Patna Medical College and Hospital, Patna from May 2018 to April 2019. All consecutive patients with a diagnosis of Fournier’s Gangrene were studied for clinico-pathological features, management and outcome. Result: There were 58 patients; all were male. The source of infection was urological in 30 patients, anorectal in 10 and cutaneous in 7, while no cause was found in 11 patients. Ma- jority presented with erythema and swelling of genitalia, while 33 had fever, 55 had pain, 24 crepitus, and 18 septic shock. E.coli was the most common organism isolated in 29 patients. Other organisms included Acinetobacter in 10, Klebsiella in 5 and Candida in 3 patients. The overall mortality rate was 30%. Sepsis, advanced age, renal failure on admission, extension of infection onto abdominal wall, full-blown shock on presentation and need for mechanical ventilation were the main risk factors contributing to mortality. Conclusion: Fournier gangrene is a surgical emergency with high mortality rates. Early man- agement with aggressive debridement, broad spectrum antibiotics and intensive supportive care has improved the outcome in recent years.