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Ann Coloproctol 2021 May 28. Epub 2021 May 28.

Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Korea.

Rare cases of Fournier gangrene (FG) possibly associated with sodium-glucose cotransporter 2 inhibitors have been reported. We present a case of a 66-year-old male patient with type 2 diabetes mellitus on oral metformin, glimepiride, and dapagliflozin therapy. He presented with pain in the perineum and scrotum for 5 days. Read More

Urology 2021 May 17. Epub 2021 May 17.

Department of Urology, Vanderbilt University Medical Center, 1211 Medical Center Dr, Nashville, TN 37215.

Genitourinary infections are commonly encountered and managed in inpatient, outpatient and emergency settings. Fournier's Gangrene, emphysematous pyelonephritis and obstructive pyelonephritis represent the most serious urologic infections and have a high risk of mortality if not managed promptly. Due to the rarity of these infections, the evidence for specific treatment strategies is scattered. Read More

Urol Case Rep 2021 Sep 25;38:101689. Epub 2021 Apr 25.

HCA Healthcare University of Central Florida Graduate Medical Consortium Emergency Medicine Residency Program of Greater Orlando Author Contributions, USA.

Despite its rarity, Fournier's gangrene remains a potentially deadly disease. Rapid assessment and treatment is absolutely critical for patient survival. We present herein a classic case of Fournier's gangrene in an older male with uncontrolled diabetes mellitus and hypertension, including ultrasonographic and computed tomography imaging. Read More

Int J Appl Basic Med Res 2021 Apr-Jun;11(2):106-107. Epub 2021 Apr 8.

Department of General Surgery, VMMC and Safdarjung Hospital, New Delhi, India.

Fournier's gangrene and inguinal hernia, both are common diseases. However, inguinal hernia in a case of Fournier's gangrene is rarest of rare cases. Only one such case is reported in literature. Read More

Med Klin Intensivmed Notfmed 2021 May 20;116(4):361-372. Epub 2021 Apr 20.

Urologische Klinik und Poliklinik, Universitätsmedizin Rostock, Rostock, Deutschland.

As a result of the restructuring of emergency care provided by statutory health insurance companies and demographic change, the number of people presenting to emergency departments in hospitals is continuously increasing. A significant proportion of these emergencies concern the specialist discipline of urology. The clinical manifestations in emergency medical care range from trauma-related injuries to the urogenital tract and urinary transport disorders to hematuria and life-threatening infections. Read More

BMJ Case Rep 2021 Apr 19;14(4). Epub 2021 Apr 19.

Plastic Surgery, JIPMER, Puducherry, India.

Urethrocutaneous fistula (UCF) poses a challenge to the reconstructive urologist in terms of its location, patient's expectations, availability of tissues for interposition, wound infection and chances of recurrence. Also, patient-related factors, such as uncontrolled diabetes, local surgery with extensive tissue loss, prior history of radiation, poor nutritional status and presence of any distal obstruction in the urethra severely affect the outcomes of a good repair with vascularised flap. We report two cases of UCF repair in adults using scrotal and gracilis muscle flaps (GMFs), their anatomic basis, technicality and advantages. Read More

BMJ Case Rep 2021 Apr 15;14(4). Epub 2021 Apr 15.

Plastic Surgery, Beaumont Hospital - Farmington Hills, Farmington Hills, Michigan, USA.

The patient is a 45-year-old man diagnosed with Fournier's gangrene and underwent treatment for septic shock, broad-spectrum antibiotic therapy and extensive surgical debridement of perineum, including total scrotectomy, ischiorectal fossa, abdomen and left superior thigh and flank. The patient required multiple staged complex reconstruction of the scrotum utilising prelaminated superior medial thigh flaps with use of dermal matrix, split-thickness skin grafting and pedicled gracilis muscle flap for coverage of the ischiorectal wound. The patient had full recovery and followed up 1 year postoperatively. Read More

Pan Afr Med J 2021 12;38:23. Epub 2021 Jan 12.

Department of General and Digestive Surgery, University Hospital Fattouma Bourguiba, University of Monastir, Monastir, Tunisia.

Fournier's gangrene (FG) is a rapidly progressive necrotizing bacterial dermo-hypodermitis of the perineum and external genitalia. It represents a real medical and surgical emergency requiring multidisciplinary care. Our study was based on the retrospective analysis of 18 cases of FG, collected in the Department of General and Visceral Surgery of Fattouma Bourguiba University Hospital in Monastir over an 18-year period extending from January 2000 to December 2018. Read More

Transplant Proc 2021 May 26;53(4):1281-1283. Epub 2021 Mar 26.

Division of Nephrology and Renal Transplantation, Department of Medicine, Centro Hospitalar Lisboa Norte, Lisbon, Portugal.

Fournier gangrene is a progressive necrotizing infection of the external genitalia or perineum that constitutes a urologic emergency. Incidence of Fournier gangrene is rising because of population aging, increasing comorbidities, and widespread use of immunosuppressive therapy, including immunosuppressive regimens used in kidney transplants. This is a rapidly progressive and potentially lethal disease without treatment, and early recognition of the disease, proper management of the predisposing factors, and aggressive surgical debridement are the most essential interventions. Read More

Nephrol Ther 2021 Jun 25;17(3):143-148. Epub 2021 Mar 25.

Service de néphrologie-HTA, dialyses et transplantation rénale, hôpital Bretonneau, CHU de Tours, 2, boulevard Tonnellé, 37044 Tours cedex, France. Electronic address:

Since 2015, 10 randomized clinical trials assessed the cardiovascular safety of SGLT2 inhibitors, and then assessed the potential renal and cardiovascular benefits of these drugs (EMPAREG Outcome, CANVAS, DECLARE, DAPA-HF, CREDENCE, EMPEROR-reduced, VERTIS, DAPA-CKD, SCORED, SOLOIST-WHF) in over 88,000 patients. The results of EMPAREG Outcome showed major renal and cardiovascular protection but they were unexpected. The other trials regarding the effects of dapagliflozin, canagliflozin, empagliflozin and more recently sotagliflozin have confirmed most of these results and extended them to other populations. Read More

Mil Med 2021 Mar 20. Epub 2021 Mar 20.

Emergency Medicine, San Antonio Military Medical Center, Fort Sam Houston, TX 78234, USA.

Cellulitis and abscess are common skin infections in military populations. Although complications of necrotizing soft tissue infections (NSTIs) such as Fournier Gangrene (FG) are rare, they are associated with significant morbidity and mortality. Laboratory and radiological studies may aid in the evaluation of NSTI; however, focus should remain on physical examination and prompt surgical consultation, as these infections can spread rapidly with significant increases in mortality with delayed management. Read More

Urol Case Rep 2021 Jul 17;37:101608. Epub 2021 Feb 17.

Urology Department, Les Aghlabites Surgical Division, Ibn El Jazzar Teaching Hospital, Kairouan, Tunisia.

Comparatively to scrotal gangrene, isolated penile gangrene is very rare due to the rich blood supply of the organ. It is thought to be initiated by a traumatic or vascular insult to the penis. This condition requires parenteral antibiotic therapy and serial debridement of necrotic tissue. Read More

Prague Med Rep 2021 ;122(1):39-44

University Clinic of Abdominal Surgery, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, Skopje, North Macedonia.

Fournier's gangrene (FG) is a necrotizing fasciitis of the genital, perianal and perineal regions, caused by multiple anaerobic/aerobic infection. It is a rare but very serious condition with multiple long-term complications and high mortality rate. Early diagnosis and multidisciplinary approach in treatment of complicated cases of FG are crucial to the successful outcome. Read More

Am J Med 2021 03;134(3):e234

Department of Surgery, Tokyo Nishi Tokushukai Hospital, Tokyo, Japan.

Urologe A 2021 May 9;60(5):610-616. Epub 2021 Feb 9.

Urologische Klinik und Poliklinik, Universitätsmedizin Rostock, Schillingallee 35, 18055, Rostock, Deutschland.

Background: Fournier's gangrene (FG) is a sporadic and life-threatening disease, but the outcome has not improved in recent years.

Objectives: The primary aim of this study was the description of current practice patterns in German academic medicine. The secondary aim was the identification of factors associated with a higher mortality rate. Read More

BMJ Case Rep 2021 Feb 1;14(2). Epub 2021 Feb 1.

Clinical Pharmacy Department, Winchester District Memorial Hospital, Winchester, Ontario, Canada.

Sodium-glucose cotransporter 2 (SGLT2) inhibitors, which are used for treatment of type 2 diabetes, are associated with risk of urogenital infections. FDA issued a black box warning about multiple case reports of Fournier's gangrene (FG) observed in patients taking SGLT2 inhibitors. FG is a type of necrotising fasciitis that occurs in the anogenital area. Read More

AJR Am J Roentgenol 2021 03 13;216(3):812-823. Epub 2021 Jan 13.

Department of Radiology, Ohio State University Wexner Medical Center, Columbus, OH.

The purpose of this article is to review the spectrum, etiopathogenesis, clinical presentation, imaging features, differential diagnoses, and management of emphysematous infections of the abdomen and pelvis. Emphysematous infections are associated with high morbidity and mortality and thus need urgent medical and surgical interventions. CT is the most sensitive modality to detect gas; CT provides definitive diagnosis in most cases and can depict the extent of involvement. Read More

Am J Med 2021 03 16;134(3):e233. Epub 2020 Dec 16.

Division of Endocrinology, Department of Medicine, Nassau University Medical Center, East Meadow, NY. Electronic address:

J Vasc Interv Radiol 2021 04 16;32(4):634-636. Epub 2020 Dec 16.

Department of Radiology, Instituto de Radiologia, Faculdade de Medicina da Universidade de São Paulo and Instituto do Cancer do Estado de São Paulo, Av. Dr. Enéas de Carvalho Aguiar, s/n˚ - Rua 1 - Cerqueira César, 05403-900, São Paulo, Brazil; Interventional Radiology Unit, Hospital São Camilo de São Paulo, Av. Pompeia, 1178, Pompeia, 05022-001; São Paulo, Brazil.

Infect Disord Drug Targets 2020 Nov 17. Epub 2020 Nov 17.

Department of Microbiology, Government Medical College and Hospital, Chandigarh sector 32. India.

Introduction: Human Salmonella infections have been classically distinguised into diseases caused by typhoidal and non-typhoidal salmonella (NTS). Typhiodal salmonella includes S. enterica serovars Typhi and Paratyphi that cause the systemic disease but are restricted to human infections, while NTS consists mainly of other serovars that predominantly cause self-limiting gastroenteritis in humans. Read More

Open Access Emerg Med 2020 9;12:353-364. Epub 2020 Nov 9.

Department of Emergency Medicine, Brooke Army Medical Center, San Antonio, TX, USA.

Fournier gangrene (FG) is a rare and life-threatening urosurgical emergency characterized most often by a polymicrobial infection of the perineal, genital, or perianal region. FG has an increased incidence in male patients, patients with alcoholism, and patients with immunocompromise including human immunodeficiency virus (HIV) and uncontrolled diabetes. FG often begins as a simple abscess or cellulitis with progression to necrotizing soft tissue infection (NSTI). Read More

Int Urol Nephrol 2021 Apr 13;53(4):641-653. Epub 2020 Nov 13.

Department of Surgery/Urology, School of Medicine, Universidad del Valle, Cali, Colombia.

Purpose: To determine the effectiveness of Vacuum-Assisted Closure Device in the postoperative wound care for Fournier's gangrene METHODS: We performed a systematic review in the following databases: Medline (Ovid), EMBASE, and The Cochrane Central Register of Controlled Trials (CENTRAL), from inception to nowadays. We included RCTs and analytical observational studies. Meta-analysis was not possible given the clinical and methodological heterogeneity of the studies. Read More

Plast Reconstr Surg Glob Open 2020 Sep 23;8(9):e3135. Epub 2020 Sep 23.

Department of Plastic and Reconstructive Surgery, Yachiyo Medical Center, Tokyo Women's Medical University, Yachiyo-shi, Chiba, Japan.

Despite medical advances, the mortality rate associated with Fournier gangrene has remained largely unchanged and extremely high. In addition, conventional surgical treatment of Fournier gangrene of the scrotum requires excision of the testicles in some cases, which can result in loss of fertility. We report herein the favorable results of reconstruction of the scrotum following Fournier gangrene, using the hydrosurgery system and pedicled deep inferior epigastric perforator flap. Read More

BMJ Case Rep 2020 Oct 30;13(10). Epub 2020 Oct 30.

Department of Urology, Maine Medical Center, Portland, Maine, USA.

There are few reports of radiation associated colorectal-genitourinary tract (CRGU) fistulae causing Fournier's gangrene (FG). We describe a case of FG in a patient with possibly two CRGU fistulae in the context of previous high-dose brachytherapy and external beam radiation therapy for prostate cancer. Unfortunately, CRGU fistulae are not well classified as significant risk factors for the development of FG. Read More

BMC Surg 2020 Oct 30;20(1):259. Epub 2020 Oct 30.

General Surgery, Jilin University Second Hospital, No 218 ZiQiang Street, Changchun, 130000, China.

Background: To describe the clinical characteristics and management for Fournier's gangrene. Experience summary and literature references are provided for future treatment improvement.

Methods: We retrospectively reviewed the cases diagnosed with Fournier's gangrene in our department from June 2016 to June 2019. Read More

Urol Case Rep 2020 Nov 11;33:101378. Epub 2020 Aug 11.

Department of Urology, Faculty of Medicine Universitas Padjadjaran, General Hospital Hasan Sadikin Bandung, Indonesia.

Complete urethral disruption due to urethral catheterization is rarely documented. Only seven cases of iatrogenic complete urethral disruption were reported from 1997 to 2003. We describe a case of complete urethral disruption due to urethral catheterization in an 80-year-old male who was referred because of a scrotal mass. Read More

Urol Case Rep 2020 Nov 15;33:101345. Epub 2020 Jul 15.

Northeast Ohio Medical University (NEOMED) School of Medicine, 4209 OH-44, Rootstown, OH, 44272, USA.

Fournier's gangrene is a life-threatening type of necrotizing fasciitis associated with a high rate of morbidity and mortality. The patient is a 29-year-old incarcerated male who presented to the ED with left-sided scrotal crepitus extending into the axilla and testicular swelling. The patient endorsed a pimple on his left scrotum accompanied with groin pain. Read More

Urol Case Rep 2020 Nov 16;33:101299. Epub 2020 Jun 16.

Department of Surgery, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran.

We report a case of cooccurrence of xanthogranulomatous and emphysematous pyelonephritis along with necrotizing fasciitis (NF) of scrotum and premium in a patient was nondiabetic and the history of kidney stones. This case a unique presentation of NF due to two pyelonephritis causing fournier gangrene. Surgical management and antibiotics provide an effective management of the disease. Read More

Urol Ann 2020 Jul-Sep;12(3):248-253. Epub 2020 Jul 17.

Department of Surgery, Urology, Surgery Units, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria.

Introduction: Fournier's gangrene (FG) is a necrotizing fasciitis of the external genitalia and perineum but may involve upper thigh and anterior abdominal wall.

Patients And Methods: This is a retrospective study of 47 patients managed for FG at Usmanu Danfodiyo University Teaching Hospital from January 2001 to June 2017. Data were entered into a semi-structured pro forma and analyzed using SPSS version 20. Read More

Drug Saf 2020 12 23;43(12):1211-1221. Epub 2020 Oct 23.

Department of Diabetes and Endocrinology, St. Vincent's Hospital, Sydney, Australia.

Sodium-glucose cotransporter 2 (SGLT2) inhibitors are a major advance in the fields of diabetology, nephrology, and cardiology. The cardiovascular and renal benefits of SGLT2 inhibitors are likely largely independent of their glycaemic effects, and this understanding is central to the use of these agents in the high-risk population of people with type 2 diabetes and chronic kidney disease. There are a number of potential safety issues associated with the use of SGLT2 inhibitors. Read More