Case Study : Diagnosis and Management of Fournier Gangrene in a Female patient in Aeramo-Flores Hospital 2021
DOI:
https://doi.org/10.31004/jptam.v7i3.8665Keywords:
Fournier, Gangren, WanitaAbstract
Fournier gangrene adalah infeksi nekrotik akut yang terjadi secara cepat dan progresif. Fournier Gangrene menyebabkan kematian jaringan pada bagian dalam dari jaringan perineal ,genital, anus, dan kulit perut bagian bawah yang berpotensi fatal. Hal ini ditandai dengan keluhan nyeri dan kemerahan pada area genital dengan perkembangan cepat menjadi gangrene. Fournier gangrene biasanya menyerang pria, tetapi wanita juga dapat mengalami infeksi nekrotik sejenis ini. Kami melaporkan kasus fournier gangrene pada wanita berusia 58 tahun dengan penyakit penyerta berupa post stroke, hidradenitis supurativa, infeksi saluran kemih, diabetes melitus tipe II tidak terkontrol, anemia, dan hipoalbumin serta CAD. Dengan keterbatasan fasilitas, diagnosis ditegakkan secara anamnesis dan pemeriksaan klinis dengan ditemukannya benjolan fluktuatif dan nyeri di kemaluan sisi kanan hingga bokong, sebagian ditutupi oleh jaringan nekrotik, mengeluarkan nanah dan terdapat krepitasi, disertai keluhan demam dan nyeri berkemih. Pemeriksaan penunjang yang dapat dilakukan berupa pemeriksaan darah lengkap, GDS, dan albumin. Pada penanganan dilakukan operasi debridement necrotomy, Pemberian diet tinggi kalori tinggi protein, Transfusi PRC 2 x 250 ml. Terapi antibiotik berupa Ceftriaxone 2 x 1 gr dan metronidazole 3 x 500 mg, dan perawatan luka setiap hari. Dengan mengetahui diagnosis dan tatalalaksana dari fournier gangrene, kasus ini dapat dilakukan pada Rumah Sakit Tipe D dengan kerjasama seluruh SDM meskipun memiliki keterbatasan fasilitas.
References
Aslanidis, T., Myrou, A., & Giannakou-Peftoulidou, M. (2014). Management of a young female patient with Fournier’s gangrene and Lemierre’s syndrome. Pan African Medical Journal, 18(1).
Ballard, D. H., Mazaheri, P., Raptis, C. A., Lubner, M. G., Menias, C. O., Pickhardt, P. J., & Mellnick, V. M. (2020). Fournier gangrene in men and women: appearance on CT, ultrasound, and MRI and what the surgeon wants to know. Canadian Association of Radiologists Journal, 71(1), 30-39.
Chawla, S. N., Gallop, C., & Mydlo, J. H. (2003). Fournier’s gangrene: an analysis of repeated surgical debridement. European urology, 43(5), 572-575.
Chen, Y., Wang, X., Lin, G., & Xiao, R. (2018). Successful treatment following early recognition of a case of Fournier’s scrotal gangrene after a perianal abscess debridement: a case report. Journal of medical case reports, 12(1), 1-5.
Chernyadyev, S. A., Ufimtseva, M. A., Vishnevskaya, I. F., Bochkarev, Y. M., Ushakov, A. A., Beresneva, T. A., ... & Khodakov, V. V. (2018). Fournier’s gangrene: literature review and clinical cases. Urologia internationalis, 101(1), 91-97.
Doluo?lu, Ö. G., Karagöz, M. A., K?l?nç, M. F., Karakan, T., Yücetürk, C. N., Sar?c?, H., ... & Ero?lu, M. (2016). Overview of different scoring systems in Fournier’s Gangrene and assessment of prognostic factors. Turkish journal of urology, 42(3), 190.
El-Qushayri, A. E., Khalaf, K. M., Dahy, A., Mahmoud, A. R., Benmelouka, A. Y., Ghozy, S., ... & Abdel-Daim, M. M. (2020). Fournier’s gangrene mortality: A 17-year systematic review and meta-analysis. International Journal of Infectious Diseases, 92, 218-225.
Garg, G., Singh, V., Sinha, R. J., Sharma, A., Pandey, S., & Aggarwal, A. (2019). Outcomes of patients with Fournier’s Gangrene: 12-year experience from a tertiary care referral center. Turkish journal of urology, 45(Suppl 1), S111.
Mallikarjuna, M. N., Vijayakumar, A., Patil, V. S., & Shivswamy, B. S. (2012). Fournier’s gangrene: current practices. International Scholarly Research Notices, 2012.
Majdoub, W., Mosbahi, A., & Bonbled, F. (2019). Sudden unexpected death due to Fournier gangrene. Forensic Science, Medicine and Pathology, 15(1), 155-158.
Misiakos, E. P., Bagias, G., Patapis, P., Sotiropoulos, D., Kanavidis, P., & Machairas, A. (2014). Current concepts in the management of necrotizing fasciitis. Frontiers in surgery, 1, 36.
Nisbet, A. A., & Thompson, I. M. (2002). Impact of diabetes mellitus on the presentation and outcomes of Fournier’s gangrene. Urology, 60(5), 775-779.
Patel, P., Peer, M. S., Briggs, B., Smith, T., & O’Brien, M. C. Necrotizing Fasciitis: Flesh Eating Bacteria.
Sen, H., Bayrak, O., Erturhan, S., Borazan, E., & Koc, M. N. (2016). Is hemoglobin A1c level effective in predicting the prognosis of Fournier gangrene?. Urology Annals, 8(3), 343.
Shyam, D. C., & Rapsang, A. G. (2013). Fournier's gangrene. The Surgeon, 11(4), 222-232.
Tahmaz, L., Erdemir, F., Kibar, Y., Cosar, A., & YalcÝN, O. (2006). Fournier’s gangrene: Report of thirty?three cases and a review of the literature. International journal of urology, 13(7), 960-967.
Y?lmazlar, T., I??k, Ö., Öztürk, E., Özer, A., Gülcü, B., & Ercan, ?. (2014). Fournier’s gangrene: review of 120 patients and predictors of mortality. Ulus Travma Acil Cerrahi Derg, 20(5), 333-7.
Downloads
Published
How to Cite
Issue
Section
Citation Check
License
Copyright (c) 2023 Purba Lamhot Farma
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work’s authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal’s published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).
