FOURNIER’S GANGRENE: A MICROBIOLOGICAL OVERVIEW
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2016, Vol 5, Issue 1
Abstract
Fournier’s gangrene (FG) is a rare, rapidly progressive, fulminant form of necrotizing fasciitis of the genital, perianal and perineal region and is usually secondary to polymicrobial infection. OBJECTIVES Presently, the literature regarding the spectrum of pathogens causing FG is limited. Hence, this study was undertaken to get a better understanding of (a) Microbial pathogens causing FG and (b) The clinical outcome. METHODS The present study is a retrospective cohort study of the microbial pathogens isolated from FG patients admitted in a tertiary care centre. Data was collected from the hospital records of patients admitted with FG during June 2012 to November 2015. RESULTS A total of 55 male patients with FG were included in this study. The mean age of patient was 49.36 years. Out of 55 samples, 47- showed evidence of microbial growth, 12 samples showed mono-microbial and 35 samples showed poly-microbial growth. Among the cases included in the present study, anaerobic culture was requested for only 10 samples; 3 out of the 10 samples subjected to anaerobic culture yielded Bacteroides fragilis (B. fragilis). Klebsiella pneumoniae was the most common pathogen isolated (K. pneumoniae) (29/47, 61.70%), followed by Enterococcus faecalis (E. faecalis) (15/47, 31.91%), B. fragilis (3/10, 30%) and Escherichia coli (E. coli) (13/47, 27.65%). Gram negative organisms were highly susceptible to levofloxacin and piperacillin– tazobactam. Gram positive organisms were highly susceptible to linezolid (92%), vancomycin (84%) and tetracycline (68%). Major risk factors associated with FG were diabetes (43.6%) and obesity (40%). The mortality rate was 5.45%. CONCLUSION FG is a rapidly progressive fulminant life threatening condition. Early diagnosis, aggressive surgical intervention and appropriate antimicrobial therapy may help to reduce the mortality rate.
Authors and Affiliations
Anjana Gopi , Vinoba S, Neetha Murthy, Swati Jain, Faiza Samreen
Keywords
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- EP ID EP143997
- DOI 10.14260/jemds/2016/10
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