Fournier gangrene: Difference between revisions
| Line 10: | Line 10: | ||
==Treatment== | ==Treatment== | ||
*Abx | *Abx | ||
**Must cover gram positive, gram negative, and anaerobes | **Must cover [[gram positive]], [[gram negative]], and [[anaerobes]] | ||
***Vancomycin + (imipenem 1gm IV q24hr OR meropenem 500mg-1gm IV q8hr) | ***[[Vancomycin]] + (imipenem 1gm IV q24hr OR meropenem 500mg-1gm IV q8hr) | ||
*Surgical debridement | *Surgical debridement | ||
Revision as of 07:54, 3 March 2014
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)
- Must cover gram positive, gram negative, and anaerobes
- 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
Source
Tintinalli