Departmental Bulletin Paper Fournier's gangrene – a case report –

Miyamoto, Takashi  ,  Fukushima, Tatsuya  ,  Taguchi, Kenji  ,  Sata, Kiyoshi  ,  Yonekura, Akihiko  ,  Tomita, Masato  ,  Osaki, Makoto

61 ( 1 )  , pp.37 - 40 , 2017-01 , Nagasaki University School of Medicine
We report a case of Fournier's gangrene in a patient with underlying untreated diabetes. A 42-year-old woman noticed induration of the left vulva and was prescribed antibiotics by a local physician. However, symptoms were unimproved, so she was transferred for further evaluated in the Department of Obstetrics and Gynecology at our hospital. A soft tissue infection was suspected, and she was referred to our department. The patient had a temperature of 38.8°C, examination revealed erythema and swelling extending from the left vulva to the left medial thigh, and blood tests indicated a high degree of inflammation. Plain radiography showed gas formation in the left inguinal region, and magnetic resonance imaging (MRI) revealed necrotizing fasciitis. Fournier's gangrene was diagnosed, and emergency debridement was performed. The infection subsided with antibiotic therapy and repeated debridements. Fournier's gangrene can be fatal if diagnosed late. Early diagnosis by MRI, defining the extent of necrosis, and early debridement are useful. Negative pressure wound therapy (NPWT) was useful to treat the open wound after debridement.

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