FOURNIER'S GANGRENE: CLINICAL, BIOCHEMICAL, BACTERIOLOGIC, IMMUNOLOGIC STUDY AND TREATMENT OUTCOME | ||
| The Egyptian Journal of Surgery | ||
| Volume 26, Issue 2, April 2007, Pages 63-69 PDF (224.99 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/ejsur.2007.372320 | ||
| Authors | ||
| Saleh El Awady* 1; Wael Khafagy1; Mohamed Fareed1; Mohamed Abd El-Raof2; Elham Ragab3 | ||
| 1Surgery, Mansoura University Hospital, Egypt | ||
| 2Mansoura General Hospital | ||
| 3Clinical Pathology, Mansoura University Hospital, Egypt | ||
| Abstract | ||
| Aim: Identify Fournier’s disease associations, outcome and survival factors. Methods: Fournier’s gangrene patients (34) were treated between 2003 to 2006. Data were collected about medical history, physical findings, metabolic tests, bacteriologic typing, immunologic screening for T cell function, serum IL-2, ICAM-I and γIFN with their management. Results: The disease had age range 3 – 67 years, polymicrobial nature, and low serum albumin (3.3 ± 0.6 mg/dl). Inadequate Tcell function (18255.3 ± 1641 CPM) and high ICAM-I, IL-2, γIFN (10.5 ± 0.7, 93.3 ± 1.6, 131 ± 2 pg/ml) were detected in Fournier’s disease but serum IL-2 was relevant to outcome (P = 0.0001). The survival factors were patients’ age (P = 0.0001), presentation timing (P = 0.001), both disease extent (P = 0.0001),septic shock(P = 0.01),severe SIRS (P = 0.001), serum albumin(P = 0.0001) and IL-2. Conclusion: Fournier’s disease is consistent with deviated metabolic status and immunologic dissonance, inciting local gangrenous process, these parameters are significant for disease outcome. | ||
| Keywords | ||
| Necrotizing fasciitis; immunologic dissonance; SIRS | ||
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