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Flashcards in Fournier's gangrene Deck (12)
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1
Q

What is Fourniers gangrene?

A

necrotising fasciitis that affects the perineum

2
Q

What is necrotising fasciitis?

A

rapidly spreading necrosis of subcutaneous tissue and fascia

3
Q

What kind of infections can Fourniers gangrene be?

A

monomicrobial or polymicrobial infection with causative organisms including group A streptococcus, C perfringes and E coli

4
Q

What are the anatomic barriers to Fourniers gangrene?

A

Dartos fascia of the penis and scrtum, collet fascia of the perineum and scrapa fascia of the anterior abdominal wall so the testes and epididymis are not usually affected

5
Q

What are the risk factors for Fourniers gangrene?

A

Diabetes mellitus, excess alcohol, poor nutritional state, steroids, haematological malignancies, recent trauma to the region

6
Q

What are the clinical features of Fourniers gangrene?

A

Severe pain, pyrexia, non specific usually, credits, skin necrosis, haemorrhage bullae, rapidly deteriorate

7
Q

What is the differential diagnosis for Fourniers gangrene?

A

cellulitis, testicular torsion and epididmyo-orchitis

8
Q

How would you diagnose Fourniers gangrene?

A

mainly clinically but would do a blood test, blood cultures, CT would show fascial swellings but is less specific

9
Q

What does LRINEC stand for?

A

Laboratory risk indicator for necrotising fasciitis

10
Q

What LRINEC score means diagnosis of necrotising fasciitis on lab results alone?

A

6 or greater

11
Q

What is the management for Fourniers gangrene?

A

Urgent surgical debridement, partial or total orchiectomy, broad spectrum antibiotics and put in high dependancy setting, fluids, second surgical debridement and usually skin grafts are needed

12
Q

What levels are measured in the LRINEC?

A

CRP, white cell count, haemoglobin, serum sodium, creatinine and glucose