Fournier gangrene in tuberculosis patients

Abstract

Introduction. Fournier gangrene is a life-threatening form of perineal necrotizing infection characterised by affecting immucompromised patients, including those with tuberculosis.Objective. To evaluate the treatment results of patients with Fournier gangrene and tuberculosis process.Materials & methods. Five case histories of patients diagnosed with "Fournier gangrene" at the Tuberculosis Extrapulmonary Division of Clinic No. 2, Moscow Research Clinical Centre for Tuberculosis Control from 2012 to 2022 were analysed retrospectively using the continuous method. The Fournier's Gangrene Severity Index (FGSI) was used for assessment.Results. The analysis of case histories revealed the main features of management in patients with Fournier gangrene whose underlying process was tuberculosis. Our clinical experience confirms the role of Mycobacterium tuberculosis as a specific agent, as well as an immunosuppression factor in the development of Fournier’s gangrene. One should be wary of this pathology in patients with tuberculosis. The aggressive nature of the infectious process dictates the need for early detection of this disease for competent comprehensive treatment, including early rehabilitation of chronic foci of infection in patients with urogenital pathology and reconstructive-plastic methods of surgical treatment.Conclusion. Fournier gangrene in tuberculosis patients is a rare difficult-to-treat disease accompanied in most cases by septic shock and a high mortality risk. Alertness towards Fournier gangrene in patients with tuberculosis, correctly chosen treatment tactics reduces the risk of lethal outcomes.