Diagnosis and Treatment of Fournier Syndrome (Report of 6 Cases)_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

WANG Ju , WANG Tianfu , LIU Dan , WANG Lei.

Department of Colorectal and Anal Surgery, The First Hospital, Jilin University, Changchun 130021, China;

Corresponding author：

Keywords：

Infection; Perianal abscess; Necrotizing fasciitis; Fournier syndrome

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Objective To investigate the early diagnosis and effective treatment of Fournier syndrome.
Methods The clinical data of 385 patients with perianal abscess in this hospital between 2006 and 2009 were retrospectively analyzed for screening the patients with complication of Fournier syndrome.
Results Fournier syndrome was detected in 6 patients （1.56%）， who were all cured by treating with early incision and drainage, complete debridement, effective antibiotics, and supporting therapy.
Conclusions Perianal abscess can induce Fournier syndrome of perineal, genital, and abdominal wall regions, which spreads rapidly and progressively, so early diagnosis and extensive surgical debridement play a decisive role on the prognosis.

Citation： WANG Ju,WANG Tianfu,LIU Dan,WANG Lei.. Diagnosis and Treatment of Fournier Syndrome (Report of 6 Cases). CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2010, 17(9): 967-969. doi: Copy

1.	Timerbulatov VM, Khasanov AG, Timerbulatov MV. The Fournier’s gangrene [J]. Khirurgiia (Mosk)， 2009; (3): 2628.
2.	Golger A, Ching S, Goldsmith CH, et al. Mortality in patients with necrotizing fasciitis [J]. Plast Reconstr Surg， 2007； 119(6): 18031807.
3.	Vescio G, Battaglia M, Sommella L, et al. Fournier syndrome: multidisciplinary approach [J]. Ann Ital Chir， 2001； 72(3): 355359.
4.	Sarani B, Strong M, Pascual J, et al. Necrotizing fasciitis: current concepts and review of the literature [J]. J Am Coll Surg， 2009； 208(2): 279288.
5.	Wong CH, Chang HC, Pasupathy S, et al. Necrotizing fasciitis: clinical presentation, microbiology, and determinants of mortality [J]. J Bone Joint Surg Am， 2003； 85A(8): 14541460.
6.	Taviloglu K, Cabioglu N, Cagatay A, et al. Idiopathic necrotizing fasciitis: risk factors and strategies for management [J]. Am Surg， 2005； 71(4): 315320.
7.	Pryor JP, Piotrowski E, Seltzer CW, et al. Early diagnosis of retroperitoneal necrotizing fasciitis [J]. Crit Care Med， 2001； 29(5): 10711073.
8.	Wall DB, Klein SR, Black S, et al. A simple model to help distinguish necrotizing fasciitis from nonnecrotizing soft tissue infection [J]. J Am Coll Surg， 2000； 191(3): 227231.
9.	Wong CH, Khin LW, Heng KS, et al. The LRINEC (Laboratory Risk Indicator for Necrotizing Fasciitis) score: a tool for distinguishing necrotizing fasciitis from other soft tissue infections [J]. Crit Care Med， 2004； 32(7): 15351541.
10.	Simonart T, Nakafusa J, Narisawa Y. The importance of serum creatine phosphokinase level in the early diagnosis and microbiological evaluation of necrotizing fasciitis [J]. J Eur Acad Dermatol Venereol， 2004； 18(6): 687690.
11.	JeanCharles N, Sadler MA. Necrotizing perineal fasciitis in two paraplegic nursinghome residents: CT imaging findings [J]. Abdom Imaging, 2001； 26(4): 443446.
12.	Seok JH, Jee WH, Chun KA, et al. Necrotizing fasciitis versus pyomyositis: discrimination with using MR imaging [J]. Korean J Radiol， 2009； 10(2): 121128.
13.	Childers BJ, Potyondy LD, Nachreiner R, et al. Necrotizing fasciitis: a fourteenyear retrospective study of 163 consecutive patients [J]. Am Surg， 2002； 68(2): 109116.
14.	Singh G, Sinha SK, Adhikary S, et al. Necrotising infections of soft tissues-a clinical profile [J]. Eur J Surg， 2002； 168(6): 366371.
15.	任建安. 重症脓毒症和脓毒症休克治疗指南 [J]. 中国实用外科杂志， 2005； 25（1）： 3741.
16.	Anwar MU, Haque AK, Rahman J, et al. Early radical surgery and antimicrobial therapy with hyperbaric oxygen in necrotizing fasciitis [J]. Plast Reconstr Surg， 2008； 121(1): 360361.
17.	Purnell D, Hazlett T, Alexander SL. A new weapon against severe sepsis related to necrotizing fasciitis [J]. Dimens Crit Care Nurs， 2004； 23(1): 1823.
18.	Ekelius L, Bjrkman H, Kalin M, et al. Fournier’s gangrene after genital piercing [J]. Scand J Infect Dis， 2004； 36(8): 610612.
19.	Steinman E, Utiyama EM, Maximiniano LF, et al. Fournier syndrome: evaluation and initial treatment [J]. Rev Assoc Med Bras， 1992； 38(4): 209213.

1. Timerbulatov VM, Khasanov AG, Timerbulatov MV. The Fournier’s gangrene [J]. Khirurgiia (Mosk)， 2009; (3): 2628.
2. Golger A, Ching S, Goldsmith CH, et al. Mortality in patients with necrotizing fasciitis [J]. Plast Reconstr Surg， 2007； 119(6): 18031807.
3. Vescio G, Battaglia M, Sommella L, et al. Fournier syndrome: multidisciplinary approach [J]. Ann Ital Chir， 2001； 72(3): 355359.
4. Sarani B, Strong M, Pascual J, et al. Necrotizing fasciitis: current concepts and review of the literature [J]. J Am Coll Surg， 2009； 208(2): 279288.
5. Wong CH, Chang HC, Pasupathy S, et al. Necrotizing fasciitis: clinical presentation, microbiology, and determinants of mortality [J]. J Bone Joint Surg Am， 2003； 85A(8): 14541460.
6. Taviloglu K, Cabioglu N, Cagatay A, et al. Idiopathic necrotizing fasciitis: risk factors and strategies for management [J]. Am Surg， 2005； 71(4): 315320.
7. Pryor JP, Piotrowski E, Seltzer CW, et al. Early diagnosis of retroperitoneal necrotizing fasciitis [J]. Crit Care Med， 2001； 29(5): 10711073.
8. Wall DB, Klein SR, Black S, et al. A simple model to help distinguish necrotizing fasciitis from nonnecrotizing soft tissue infection [J]. J Am Coll Surg， 2000； 191(3): 227231.
9. Wong CH, Khin LW, Heng KS, et al. The LRINEC (Laboratory Risk Indicator for Necrotizing Fasciitis) score: a tool for distinguishing necrotizing fasciitis from other soft tissue infections [J]. Crit Care Med， 2004； 32(7): 15351541.
10. Simonart T, Nakafusa J, Narisawa Y. The importance of serum creatine phosphokinase level in the early diagnosis and microbiological evaluation of necrotizing fasciitis [J]. J Eur Acad Dermatol Venereol， 2004； 18(6): 687690.
11. JeanCharles N, Sadler MA. Necrotizing perineal fasciitis in two paraplegic nursinghome residents: CT imaging findings [J]. Abdom Imaging, 2001； 26(4): 443446.
12. Seok JH, Jee WH, Chun KA, et al. Necrotizing fasciitis versus pyomyositis: discrimination with using MR imaging [J]. Korean J Radiol， 2009； 10(2): 121128.
13. Childers BJ, Potyondy LD, Nachreiner R, et al. Necrotizing fasciitis: a fourteenyear retrospective study of 163 consecutive patients [J]. Am Surg， 2002； 68(2): 109116.
14. Singh G, Sinha SK, Adhikary S, et al. Necrotising infections of soft tissues-a clinical profile [J]. Eur J Surg， 2002； 168(6): 366371.
15. 任建安. 重症脓毒症和脓毒症休克治疗指南 [J]. 中国实用外科杂志， 2005； 25（1）： 3741.
16. Anwar MU, Haque AK, Rahman J, et al. Early radical surgery and antimicrobial therapy with hyperbaric oxygen in necrotizing fasciitis [J]. Plast Reconstr Surg， 2008； 121(1): 360361.
17. Purnell D, Hazlett T, Alexander SL. A new weapon against severe sepsis related to necrotizing fasciitis [J]. Dimens Crit Care Nurs， 2004； 23(1): 1823.
18. Ekelius L, Bjrkman H, Kalin M, et al. Fournier’s gangrene after genital piercing [J]. Scand J Infect Dis， 2004； 36(8): 610612.
19. Steinman E, Utiyama EM, Maximiniano LF, et al. Fournier syndrome: evaluation and initial treatment [J]. Rev Assoc Med Bras， 1992； 38(4): 209213.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Diagnosis and Treatment of Fournier Syndrome (Report of 6 Cases)

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