Fournier gangrene: Difference between revisions

(Created page with "==Background== *Polymicrobial necrotizing fasciitis of perineal, genital, or perianal anatomy **Microthrombosis of small subcutaneous vessels leads to gangrene of overlying skin ...")
 
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*Abx
*Abx
**Must cover gram positive, gram negative, and anaerobes
**Must cover gram positive, gram negative, and anaerobes
***(Imipenem 1gm IV q24hr OR meropenem 500mg-1gm IV q8hr) + vancomycin
***Vancomycin + (imipenem 1gm IV q24hr OR meropenem 500mg-1gm IV q8hr)
*Surgical debridement
*Surgical debridement



Revision as of 19:34, 28 February 2012

Background

  • Polymicrobial necrotizing fasciitis of perineal, genital, or perianal anatomy
    • Microthrombosis of small subcutaneous vessels leads to gangrene of overlying skin
  • Risk factors = DM, alcohol abuse

Clinical Features

  • Benign infection or simple abscess that rapidly becomes virulent
  • Marked pain, swelling, crepitus, ecchymosis

Treatment

  • Abx
    • Must cover gram positive, gram negative, and anaerobes
      • Vancomycin + (imipenem 1gm IV q24hr OR meropenem 500mg-1gm IV q8hr)
  • Surgical debridement

Disposition

  • Urologic consultation, in addition to surgery consultation, is required if:
    • Periurethral abscess is inciting event
    • Infection has secondarily invaded the urinary tract and a suprapubic catheter is needed

See Also

Necrotizing Fasciitis

Source

Tintinalli