Diagnosis and treatment of one pediatric case of foreskin Fournier’s gangrene and review of the literature

Abstract

Objective To emphasize the importance of identification, early diagnosis and treatment for foreskin Fournier’s gangrene. Methods The clinical data were obtained from a child of foreskin Fournier’s gangrene. And the relevant literature information was retrieved from the databases of PubMed, Springer Link, Embase, CNKI and Wanfang until December 2015. Predisposing factors, clinical manifestations, diagnosis, treatment and prognosis were analysed. Results Rapid accurate diagnosis, early aggressive surgical intervention and usage of broad-spectrum antibiotics were essential. After circumcision surgery was implemented in the premise of complete debridement of necrotic tissue, successful postoperative outcomes were obtained. Eight cases of Fournier’s gangrene in foreskin or penial skin were reported. The median age was 14 months (14 days-14 years). There were concurrent underlying diseases of omphalitis (n=3), leukemia (n=3) and diarrhea (n=1). The average time of necrosis progress were 39 (12-48) hours until operation. Surgical debridement of necrotic tissue was performed with symptomatic supports. No deaths occurred. Conclusions Pediatric prepuce Fournier’s gangrene is rare. However, a surgeon should be fully aware of the importance of its rapid diagnosis and combined therapy to reduce suffering and improve its prognosis. Key words: Fournier gangrene; Foreskin; Child