Fournier's Gangrene at HIV Positive Patient With Normal CD4 Count

Yıl 2014, , 180 - 182, 01.05.2014

Rüçhan Bahadır Celep Mustafa Özsoy Ahmet Bal Ziya Taner Özkeçeci Ogün Erşen Yüksel Arıkan

https://doi.org/10.5505/abantmedj.2014.40427

Öz

Fournier's gangrene mainly seen in men is rapidly progressive necrotizing fasciitis and has a high mortality rate. Although the etiology of Fournier's gangrene is similar to the show soft tissue infections, the disease especially could be mortality in patients with immunosuppressive and diabetes. The main factors in treatment of the disease are early diagnosis, surgical debridement and appropriate antibiotics. In this article we aimed to present developing Fournier’s gangrene in a patient with human immunedeficiency virus HIV positive after iskiorektal abscess drainage and intended to highlight the need for early surgical debridement.

Anahtar Kelimeler

Fournier's gangrene, necrotizing fasciitis, human immunedeficiency virüs

Normal CD4 Sayılı HIV Pozitif Bir Hastada Fournier Gangreni

Öz

Fournier gangreni, ağırlıklı olarak erkeklerde görülen, hızlı ilerleyen, mortalite oranı yüksek bir nekrotizan fasiittir. Yumuşak doku enfeksiyonları ile benzer etiyoloji göstermesine karşın özellikle immünsüpressif ve diabetli hastalarda hastalık çok daha hızlı seyir göstererek mortal seyreder. Hastalığın tedavisinde ana unsurlar erken tanı, erken cerrahi debritman ve uygun antibiyoterapidir. Bu çalışma predispozan faktör olarak insan immün yetmezlik virusu HIV pozitifliği olan bir hastada iskiorektal apse drenajı sonrasında Fournier gangreni gelişimini aktarmak ve bu hastalarda erken cerrahi debritmanın gerekliliğini vurgulamak amaçlanmıştır.

Anahtar Kelimeler

Fournier gangreni, nekrotizan fasiit, insan bağışıklık yetmezlik virüsü

Kaynakça

• Thwaini A, Khan A, Malik A, Cherian J, Barua J, Shergill I, Mammen K. Fournier's gangrene and its emergency management. Postgrad Med J 2006; 82(970): 516-9.
• Morpurgo E, Galandiuk S. Fournier's gangrene. Surg Clin North Am 2002; 82(6): 1213-24.
• Sroczyński M, Sebastian M, Rudnicki J, Sebastian A, Agrawal AK. A complex approach to the treat- ment of Fournier's gangrene. Adv Clin Exp Med. 2013 Jan-Feb;22(1):131-5.
• Bjurlin MA, O'Grady T, Kim DY, Divakaruni N, Drago A, Blumetti J, Hollowell CM. Causative patho- gens, antibiotic sensitivity, resistance patterns, and severity in a contemporary series of Fournier's gangrene. Urology. 2013 Apr;81(4):752-8. doi
• 1016/j.urology.2012.12.041. Epub 2013 Feb 20.
• Romeo DY, Hervías EA, Lafuente CB, Peña MTM, Sinués EM, Toledo LS. Fournıer ́s Gangrene In A 44- Year-Old Woman: Ct Scan Fındıngs. Arch. Esp. Urol. 2009; 62 (6): 483-5
• Ndirika SC, Melville R, Green J. Fournier’s gang- rene in a man who was HIV-positive with a high CD4 count. UroToday International Journal;2010;3(5):1- 10.
• Elem B, Ranjan P. Impact of immunodeficiency virus (HIV) on Fournier's gangrene: observations in Zambia. Ann R Coll Surg Engl 1995; 77: 283-6.
• Benjelloun el B, Souiki T, Yakla N, Ousadden A, Mazaz K, Louchi A, Kanjaa N, Taleb KA. Fournier's gangrene: our experience with 50 patients and analysis of factors affecting mortality. World J Emerg Surg. 2013 Apr 1;8(1):13. doi: 10.1186/1749- 7922-8-13.
• Sroczyński M, Sebastian M, Rudnicki J, Sebastian A, Agrawal AK. A complex approach to the treat- ment of Fournier's gangrene. Adv Clin Exp Med. 2013 Jan-Feb;22(1):131-5.
• Altarac S, Katušin D, Crnica S, Papeš D, Rajković Z, Arslani N. Fournier's gangrene: etiology and out- come analysis of 41 patients. Urol Int 2012; 88(3): 289-93.