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22. Pattern of Presentations and Etiological Factors of Fournier’s Gangrene

Original Article

Factors of Fournier’s Gangrene

Pattern of Presentations and Etiological Factors of Fournier’s Gangrene

Wajeed Gul Bangash1, Muhammad Asad2, Muhammad Ismail Seerat2, Kiran Rehman2, Maryam Iftikhar2 and Sufyan Rauf2

ABSTRACT

Objective: The purpose of current study is to outline the pattern of presentation and etiological factors of Fournier’s gangrene (FG) at Pakistan Railway Hospital, Rawalpindi, Pakistan.

Study Design: A Prospective observational study

Place and Duration of Study: This study was conducted at the Pakistan Railway Hospital, Rawalpindi from Jan 2024 to June 2024.

Methods: This study included patients above the age of 13. Data collected and analyzed on predesigned proformas. 30 adult patients of FG were included in this study. The inciting event, predisposing conditions, site of involvement, microbiology and outcome were studied in these patients.

Results: The mean age for 30 patients was 54.8 ± 15.19 years. 29 (96.6%) were males and only one (3.3%) was a female. A cause could be traced back in the history of only 18 patients, 3 had urethral stone with a history of manipulation, one had paraphimosis, one had insect bite, 4 (13.3%) had of perineal abscess, 4 (13.3%) had a perirectal abscess, 5 (16.7%) had a urethral stricture. Predisposing factors were present in all of them; 20 (66.6%) were diabetic. One (3.3%) had a history of pelvic irradiation for malignancy, extremes of age (age > 70 years were present in 5 (16.6%) patients, 3 (10%) were immuno-compromised, 1 (3.3%) had a history of malignancy i.e. colonic carcinoma, 2 (6.7%) were on chronic steroid use and none had alcoholism or chemotherapy. The commonest organism isolated was E. coli. All patients were managed with surgical debridement and antibiotics. 6 (20%) patients expired.

Conclusion: FG has high mortality. In most patients the scrotum is involved, urethral strictures and stones are the commonest causes and diabetes is the commonest predisposing condition. Polymicrobial infections mostly containing E. coli and Klebsiella are the commonest.

Key Words: Fournier’s Gangrene; necrotizing fasciitis; Etiological factors

Citation of article: Bangash WG, Asad M, Seerat MI, Rehman K, Iftikhar M, Rauf S. Pattern of Presentations and Etiological Factors of Fournier’s Gangrene, Med Forum 2024;35(10):97-101. doi:10.60110/medforum.351022.