Fournier’s gangrene. Clinical and laboratory picture (literature review)

In the literature review the systematization of clinical and laboratory data pattern lightning scrotum gangrene - Fournier’s gangrene (FG) is showed, expands upon the course and stage of disease are discussed. The clinical course of FG has four successive stages of the disease: prodromal phase, of 1 - 12 days (mean, 1 - 2 days), early phase (the first 10 - 12 hours and up to 4 days), late phase (more than 12 - 14 hours and up to 4 - 12 days) and reparative phase (over 12 - 14 days). The clinical manifestations of FG are classified into local and general, local signs of the disease - on the nonspecific and specific. The early (nonspecific) symptoms of FG include pain, swelling and erythema of the external genitalia; to late (specific) features - necrosis, subcutaneous crepitus and purulent soft tissue rejection. Common clinical and laboratory manifestations of FG are non-specific, they are characterized by sepsis, septic shock and intoxication. By the permanent laboratory parameters are hyperleukocytosis GF (over 14 x 103 / ml) and hypercreatininemia (over 150 mg / dL). FG is characterized by acute onset and rapidly progressive course. The defeat of the scrotum, perineum and the penis is almost 90% of all the FG. More than half of the microflora in the FG shows microbial associations. The composition of microbial associations in the lead E. coli: 44.4% of the cases (18.9 - 62.5%). In the pathomorphological picture of early phase of FG is dominated by purulent-necrotic lesions of the superficial fascia and subcutaneous tissue of the perineum and external genital organs, thrombosis of arterioles and venules of the skin and subcutaneous tissue; late phase of the disease is characterized by necrotic changes in all layers of the skin, subcutaneous tissue, superficial and deep fascia.