The Japanese Journal of Clinical Dialysis Vol.32 No.2(6-5)

Theme Fatal infections of elderly and super-elderly dialysis patients
Title Fournier’s gangrene
Publish Date 2016/02
Author Yoshiyuki Hasegawa Hasegawa Clinic
Author Nobutoshi Kawagoe Department of Urology, Saiseikai Futsukaichi Hospital
[ Summary ] Fournier's gangrene was first reported by Jean Alfred Fournier in 1883 as an infectious disease of unknown origin which starts in the scrotum of young males and spreads rapidly to the perineum and lower abdomen. Today, this condition is described as fulminant necrotizing fasciitis of the perineum. Fournier's gangrene still has relatively high morbidity and mortality rates, with outcomes generally being poor unless appropriate treatment is provided early in the disease course. When a dialysis patient with decreased defense mechanisms against infections exhibits fever and sudden onset of erythema and swelling in the perineal area extending to the lower abdomen, Fournier's gangrene should be considered in differential diagnosis. Once this condition is diagnosed, it is important to perform emergency debridement promptly and to administer adjunctive antimicrobial therapy.
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