Dangers of delayed diagnosis of perianal abscess and undrained perianal sepsis in Fournier's gangrene: a case series. Issue 10 (4th October 2020)

• Record Type: Journal Article
• Authors: Solis, Edgardo; Liang, Yi; Ctercteko, Grahame; Toh, James Wei Tatt
• Is Part Of: BMJ case reports. Volume 13:Issue 10(2020)
• Publication Date: 2020-10-04
• Subjects: general surgery -- infectious diseases; Medicine -- Case studies -- Periodicals; 610.5
• DOI: 10.1136/bcr-2020-236503
• Languages: English
• ISSNs: 1757-790X

Abstract

Abstract : Fournier's gangrene (FG) is a rapidly progressing infective necrotising fasciitis of the perianal, perineal and genital region. It is characterised by its aggressive nature and high mortality rates of between 15% and 50%. While it has been commonly found to primarily develop from urological sources, there have been increasing reports of the role of colorectal sources as the underlying aetiology of FG. Presented is a case series of four FG presentations at a single institution during a 12-month period as a result of underlying untreated perianal disease highlighting its dangers in progressing to a deadly infection, advocating for early and aggressive surgical debridement, and the role of adjunct scoring systems, such as Laboratory Risk Indicator for Necrotising Fasciitis, in guiding clinical diagnosis.