FAQ - Fournier Gangrene
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I've just been told i have Fournier's Gangrene, what does this mean for me?


I just found out that i have Fournier's gangrene, What is my prognosis? What can i expect? I know very little about this condition.
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Fournier's Gangrene

Fournier's gangrene, sometimes called Fournier's disease, is a bacterial infection of the skin that affects the genitals and perineum (i.e., area between the scrotum and anus in men and between the vulva and anus in women). The disease develops after a wound or abrasion becomes infected.



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A combination of anaerobic (living without oxygen) microorganisms (e.g., staphylococcal) and fungi (e.g., yeast) causes an infection that spreads quickly and causes destruction (necrosis) of skin, tissue under the skin (subcutaneous tissue), and muscle. Staphylococcal bacteria clot the blood, depriving surrounding tissue of oxygen. The anaerobic bacteria thrive in this oxygen-depleted environment and produce molecules that instigate chemical reactions (enzymes) that further the spread of the infection. Fournier's gangrene can be fatal if the infection enters the bloodstream.

Incidence and Prevalence
Men are ten times more likely than women to develop Fournier's gangrene. Men aged 60-80 with a predisposing condition are most susceptible.

Women who have had a pus-producing bacterial infection (abscess) in the vaginal area, a surgical incision in the vagina and perineum to prevent tearing of skin during delivery of a child (episiotomy), an abortion resulting in fever and an infection of the lining of the uterus (septic abortion), or surgical removal of the uterus (hysterectomy) are susceptible.

Rarely, children may develop Fournier's gangrene as a complication from a burn, circumcision, or an insect bite.

Risk Factors

Men with alcoholism, diabetes mellitus, leukemia, morbid obesity, and immune system disorders (e.g., HIV, Crohn's disease), and intravenous drug users are at increased risk for developing Fournier's gangrene. The condition also can develop as a complication of surgery.

Causes

Fournier's gangrene develops when bacteria infect the body through a wound, usually in the perineum, the tube that carries urine outside the body from the bladder (urethra), or the colorectal area. Existing immune system deficiencies help infection to spread quickly, producing a disease that destroys the skin and superficial and deep fascia (membranes that separate muscles and protect nerves and vessels) of the genital area. The chambers in the penis that fill with blood to create an erection (corpora cavernosa), testicles, and urethra are not usually affected.

Signs and Symptoms



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Early physical symptoms of Fournier's gangrene may not indicate the severity of the condition. Pain sometimes diminishes as the disease progresses. Symptoms are progressive and include the following:

Crepitant ("spongy" to the touch) skin
Dead and discolored (gray-black) tissue; pus weeping from injury
Fever and drowsiness (lethargy)
Increasing genital pain and redness (erythema)
Odor
Severe genital pain accompanied by tenderness and swelling of the penis and scrotum

Diagnosis

Physical examination and blood tests are used to diagnose Fournier's gangrene and the diagnosis is made when examination reveals gangrenous (i.e., spongy, weeping, discolored) skin. Microscopic examination of a tissue specimen (biopsy) may be taken if visible symptoms are insufficient to distinguish between Fournier's and other bacterial infections.

Treatment

Antibiotics (often double or triple drug therapy) along with aggressive surgical removal of the diseased tissue is required immediately for an optimal outcome.

Without early treatment, bacterial infection enters the bloodstream and can cause delirium, heart attack, respiratory failure, and death.

Complications
Incomplete debridement (surgical removal of dead tissue) allows wound infection to continue to spread. In this event, follow-up surgery is performed.

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Fournier Gangrene treatment, Xleoda for Chemo and survival Support Group?


My husband is working with fournier gangrene and even though the gangrene is behind us, and I use the term physically, we have to use gauze to pack his opening twice daily. I can not find a support group of survivors. Are any survivors out there? And---- if your skin is very dry from Xeloda, try baby oil, it works wonders!!
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This is considered a rare condition and is listed with NORD (National Organization for Rare Disorders).

http://www.rarediseases.org/search/rdbdetail_abstract.html?disname=Fournier%20Gangrene

NORD has a message board that you can join and seek out other people with this disease. Good luck.

NORD: The Rare Disease Community
http://nord.clinicahealth.com/  (+ info)

Has ANYONE had an experience with Fournier's Gangrene? specifically that type.?


Its a gangrene infection of the male genitals

Its extremely rare only 600 cases since 1996. usually effecting men in their 60-70's concurent with diabetes. Treatment is usually antibotics and debreadment of the dead tissue  (+ info)

What is the difference between infarction and gangrene?


The morphology of both is the same,that is,ischemic necrosis.I know gangrene involves putrefaction which infarction does not.Then,why is repair by fibrosis possible only in infarction,but not in gangrene?What are the exact definitions of infarction and gangrene?Please differentiate them clearly.
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Infarction- (1) engorgement or stoppage of a vessel. (2) development or presence of an infarct (a localized area of ischemic necrosis produced by occlusion of the arterial supply or venous drainage of the part.)
Cardiac infarction- myocardial infarction.
cerebral infarction- an ischemic condition of the brain, causing a persistent focal neurological deficit in the area affected.
intestinal infarction- occlusion of an artery or arteriole in the wall of the intestine, resulting in the formation of an area of coagulation necrosis.
myocardial infarction- formation of an infarct in the heart muscle, due to interruption of the blood supply to the area.
pulmonary infarction- infiltration of an airless area of lung with blood cells, due to obstruction of the pulmonary artery by an embolus or thrombus.

gangrene- death of the tissue in considerable mass, usually associated with loss of vascular (nutritive) supply and followed by bacterial invasion and putrefaction.  (+ info)

What are the best ways to deal with gangrene besides amputation?


What are some good alternatives for diabetes-based foot gangrene if the weak ointment that the doctor gives isn't working?
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Gangrene is dead or necrotic tissue and it is usually followed by infection.. Gangrene develops when the blood supply to an affected part is cut off because of various factors including infection, vascular disease or trauma. It can involve any body part, but the commonest sites are the extremities. Can be most dangerous when gangrene affects the intestines or stomach.
Gangrene results from an infection caused by clostridia and sometimes by other bacteria. Clostridia are a type of bacteria called anaerobic bacteria, which grow only in the absence of oxygen. Clostridia produce gas as they grow, so the infection is sometimes called gas gangrene.

There are two types of gangrene: Dry gangrene - without bacterial infection and wet gangrene - with bacterial infection. Gas gangrene is a form of wet gangrene.



Causes: Gangrene is caused by interruption of blood supply to an area which causes necrosis (tissue death) and this is usually followed by a bacterial infection. Causes of gangrene are as follows: Trauma caused by accident or surgery or crash injury; Blood clot in an artery.; Hardening of arteries; Severe frostbite.


Prevention: Gangrene may be prevented by taking the following precautions: 1) Seek medical advice for signs of infection (warmth, swelling, redness, pain or tenderness) in a skin injury. 2)Avoid trauma. 3) If you have diabetes, adhere closely to your treatment program to control diabetes. Examine your feet often for signs of unhealthy tissue. Keep your nails trimmed. Wear comfortable, well-fitting shoes.


Signs & Symptoms
Black skin with dead underlying muscle and bone.

Crepitation of the skin. This feels like pressing on air bubbles under the skin.
Swelling.
Pain or loss of sensation in affected area.
Foul smelling discharge from ulcers in dead tissues.
Moderate fever up to 101(F (38.8(C) with infection.
Rapid pulse

Risk Factors
Poor blood circulation.

Diabetes mellitus.
Smoking, which impairs blood circulation
Excess alcohol consumption, which interferes with blood-vessel function.
Older age.

Diagnosis & Treatment
Diagnosis of gangrene is often made from the clinical presentation. Tests such as x-rays, computerized tomography (CT) , and magnetic resonance imaging (MRI) can help determine the amount of gas and the extent of tissue damage. Other laboratory tests include blood work and culture and sensitivity test of the fluid samples from the wound.
General Measures:
Hospitalization is necessary for treatment.
Efforts must be made to improve circulation to impaired area.
Surgery to remove dead tissue, sometimes by amputation.

Medications:
Antibiotics usually intravenously in the early stages to fight infection.
Pain relievers.
Anticoagulants to prevent blood clotting.

Activity:
Rest in bed until gangrene stops progressing and healing begins. Then resume activity gradually. Physical therapy, if amputation is necessary.


Diet:
Eat a high-protein, high-calorie diet while your body is repairing damaged tissue (except in diabetes).
Take vitamin and mineral supplements, including zinc.
Drink adequate fluids (6 to 8 glasses daily).

Possible Complications :
Blood poisoning.
Shock.
DIC (disseminated intravascular coagulation), a blood-clotting disorder.
Limb amputation to prevent death.

Prognosis
Usually curable in the early stages with antibiotic treatment and surgery to remove dead tissue. Without treatment, gangrene may lead to fatal infection

Good luck  (+ info)

How would you know if you had internal gangrene?


Many people determine gangrene based on physical appearance, but if you have internal gangrene, how would you know? A few years ago my aunt had her gallbladder taken out, and The doctors saw internal gangrene that had set up from her bad gallbladder. Out of curiosity, how would someone know of they had internal gangrene?
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If parts of their body were necrotic from an infection, they would be in excruciating pain.  (+ info)

What are my chances of getting gangrene from a self done piercing?


hello every body. Any way let's just get to the point. About a week ago I did a self piercing on my lip and im not sure if I have gangrene or any other infection. You see before I did any thing I disinfected every thing the needle, the jewlery, my hads, around my mouth, and the inside of my mouth. So Im just woundering if I have any infection or what are signs of an infection.
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Getting an infection is easy, especially from a self-piercing, but you will get an infection before it would lead to gangrene.

If you get a fever, start feeling fatigued or weak, all signs of infection... Signs of infection at the site would be redness, swelling, pus

If you get any of these, take it out and go to the doc, but if you don't get an infection first then you won't get gangrene  (+ info)

How big are the chances of gangrene to develop in an ingrown toenail?


I've heard that if an ingrown toenail is left unnoticed it can develop gangrene, but i was wondering, how big are the chances? I mean does it always happen if you leave it there, or is it in rare cases only?

Much appreciated
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You've heard wrong. Get a new source of information.  (+ info)

What does gangrene smell like? What would happen if boiling water were poured into a large infected wound?


I'm writing a story, and would like accurate information to make the situation believeable. If someone were stranded in the wilderness with a very infected large open wound (with gangrene?), would it be feasible to pour boiling water into the wound to kill the infection? Would that "cook" the flesh? Would the person go into shock? Would burns from the hot water expected to be an additional problem? Does gangrene killed by boiling water smell different afterwards?
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It smells like rotten meat because that is basically what it is. The tissue around the wound has died and no longer recieving blood flow or oxygen and the flesh and muscle etc. is now rotting. The risk of gangrene is that an infection will spread and enter the blood stream.
Boiling water would do nothing but burn the person and make things worse.  (+ info)

What are the chances of a lip piercing getting gangrene?


I'm wondering because, I know of somebody who had their lip pierced, took care of it, (apparently) and got gangrene, they nearly had to have an operation. They got this professionally done as well.
Now my parents have changed their mind, and will no longer let me get it done, as they think the chances of my lip getting infected are too high.


Please tell me the truth, about infection, or any additional details you wish to share.

Thank you. :]

I'm 15 by the way.
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If you are pierced in a sanitary studio and NEVER touch your piercing with dirty hands, your risks of infection are very, very low.

On the other hand if you touch your piercing with your dirty little hands, you are highly likely to get an infection.

So, to have the best chance of avoiding an infection go to a fabulous professional and only touch with clean hands. Clean hands are the absolute key to avoiding an infection. If you are not rubbing germs onto your piercing, there is very little chance of them getting in there on their own.

Consider all the filthy things you touch during the day: Keys, doorknobs, your own face, keyboards, your phone that hasn't been cleaned in months, the list goes on. You have all of those germs on your hands all the time and you're usually A-OK. But rubbing those germs into your brand new piercing is a recipie for disaster.

For this person you know to have been pierced in what we assume was clean studio and come down with such an incredibly virulent infection, they would have had to introduce the germ to the piercing themselves. There are plenty of nasty bacteria in the world, but they had to get into that piercing somehow. That how is probably "dirty hands."

Another point of interest is that most infections do not become so serious in a short amount of time. There are bacteria that can be nasty very quickly, so it is possible. But it is not the most likely thing. What probably happened was a nagging infection that wasn't treated properly and got out of control. The lesson is to behave as though ANY infection is serious and get proper treatment. Don't just let it go and hope it will get better.

If you take good, consistant care of your piercing, you have a normal immune system, and you are careful to wash your hands EVERY time you touch it, you are unlikely to get an infection.

As a side note, your face is not done maturing by 15 and a lip piercing you get done now may very well end up in a less than ideal spot as you grow. This is why most reputable piercers only work on clients 16 and up, and even 16 is considered young for a facial piercing. Think long and hard before you alter your body in ways that leave scars before it is done growing.  (+ info)

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