Fournier's gangrene: clinical, biochemical, bacteriologic, immunologic study and treatment outcome

ABSTRACT

Identify Fournier's disease associations, outcome and survival factors. Fournier's gangrene patients [34] were treated between 2003 to 2006. Data were collected about medical history, physical findings, metabolic test, bacteriologic typing, immunologic screening for T cell function, serum IL-2, ICAM-I and gamma IFN with their management. The disease had age range 3-67 years, polymicrobial nature, and low serum albumin [3.3 +/- 0.6mg/dl]. Inadequate T-cell function [18255.3 +/- 1641 CPM] and high ICAM-I, IL-2, gamma IFN [10.5 +/- 0.7, 93.3 +/- 1.6, 131 +/- 2 pg/ml] were detected in Fournier's disease but serum IL-2 was relevant to outcome [P=0.0001]. The survival factors were patients' age [P=0.0001], presentation timing [P=0.001], both disease extent [P=0.0001], septic shock [P=0.01], severe SIRS [P=0.001], serum albumin [P=0.0001] and IL-2. Fournier's disease is consistent with deviated metabolic status and immunologic dissonance, inciting local gangrenous process, these parameters are significant for disease outcome: