Abstract:
Fournier\'s gangrene (FG) is a perineal and abdominal necrotizing infection. It is most commonly found in middle-aged men with comorbidities such as diabetes mellitus. Initial symptoms are often indistinct and can rapidly progress to overwhelming infections with a relatively high mortality rate. It is crucial to make a prompt diagnosis so that the patient receives appropriate treatment. Given the importance of the identification of FG, we explored what were the most common signs and symptoms associated with FG, as well as distinguished the gold standard treatment. This systematic review utilized articles identified exclusively through PubMed using key terms such as Fournier\'s gangrene, signs, symptoms, and treatment. A total of 37 studies, including a total of 3,224 patients (3,093 males and 131 females), fit our inclusion parameters for relevance that included either the most identifiable presentation of FG or the most effective treatment. From our search, the most common clinical presentation was scrotal and labial pain, fever, abscesses, crepitus, erythema, and cellulitis. Diagnosis is made from clinical findings in conjunction with imaging. The gold standard for treatment was found to be a combination of surgical debridement, broad-spectrum antibiotics, and the administration of intravenous fluids. Further, patient survival was found to be directly related to the time from diagnosis to treatment when they underwent surgical debridement. The importance of early identification for improved outcomes or survival highlights the need for further studies or measures to enhance the identification of the signs and symptoms of FG.
摘要:
Fournier坏疽(FG)是会阴和腹部坏死性感染。它最常见于患有糖尿病等合并症的中年男性。最初的症状通常不明显,可以迅速发展为压倒性的感染,死亡率相对较高。做出及时的诊断是至关重要的,以便患者接受适当的治疗。鉴于识别FG的重要性,我们探索了与FG相关的最常见的体征和症状,以及尊贵的金标待遇。本系统综述使用了专门通过PubMed识别的文章,使用关键术语,如Fournier坏疽,标志,症状,和治疗。共有37项研究,包括3,224名患者(3,093名男性和131名女性),符合我们的纳入参数的相关性,包括最可识别的FG表现或最有效的治疗。从我们的搜索,最常见的临床表现是阴囊和唇疼痛,发烧,脓肿,Crepitus,红斑,和蜂窝织炎。根据临床表现结合影像学进行诊断。发现治疗的金标准是手术清创的组合,广谱抗生素,和静脉输液。Further,发现患者的生存与从诊断到接受手术清创治疗的时间直接相关.早期识别对改善结果或生存的重要性强调了需要进一步的研究或措施来增强对FG体征和症状的识别。