Fournier's Gangrene in Patients with Oncohematological Diseases: A Systematic Review of Published Cases.

Massimiliano Creta,Nicola Longo,Marco De Sio,Marco Capece,Francesco Mangiapia,Vincenzo Mirone,Antonello Sica,Caterina Sagnelli,Davide Arcaniolo,Armando Calogero,Gianluigi Califano,Ferdinando Fusco,Roberto La Rocca,Lorenzo Spirito,Giuseppe Celentano,Luigi Napolitano,Ciro Imbimbo,Luigi Vanni

doi:10.3390/healthcare9091123

Massimiliano Creta, Nicola Longo + Show 16 more

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https://doi.org/10.3390/healthcare9091123

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Abstract

Patients suffering from hematological malignancies are at increased risk of Fournier’s gangrene (FG) due to immunosuppression caused by the disease itself or by disease-related treatments. A systematic review of PubMed, ISI Web of Knowledge, and Scopus databases was performed in June 2021. We included full papers that met the following criteria: original research, human studies, and describing clinical presentation, treatment, and outcomes of FG in patients with oncohematological diseases. We identified 35 papers published from 1983 to 2021 involving 44 patients (34 males, 8 females) aged between 4 days and 83 years. The most common malignant hematological disorders were acute myeloid leukemia (n = 21) and acute lymphocytic leukemia (n = 9). In 10 patients FG represented the first presentation of hematological malignancy. Scrotum (n= 27) and perineum (n = 11) were the sites most commonly involved. Pseudomonas aeruginosa (n = 21) and Escherichia coli (n = 6) were the most commonly isolated microorganisms. Surgery was performed in 39 patients. Vacuum-assisted closure and hyperbaric oxygen therapy were adopted in 4 and in 3 patients, respectively. Recovery was achieved in 30 patients. FG-related mortality was observed in 11 patients. FG should be carefully considered in patients with oncohematological diseases.

Highlights

Fournier’s gangrene (FG) is an acute, rapidly progressive, and potentially fatal infective necrotizing fasciitis involving the perineal, genital, and perianal regions first described in 1883 by the dermatologist and venereologist Jean Alfred Fournier [1]
FG is a specific form of necrotizing fasciitis localized on the external genitalia and in the perianal region
Results from the present review demonstrate that most FG patients with hematological malignancy undergo surgical debridement, with many of them requiring additional surgical procedures

Summary

Introduction

Fournier’s gangrene (FG) is an acute, rapidly progressive, and potentially fatal infective necrotizing fasciitis involving the perineal, genital, and perianal regions first described in 1883 by the dermatologist and venereologist Jean Alfred Fournier [1]. It represents a rare condition with an overall incidence of 1.6 cases per 100,000 males and accounts for about. Subjects suffering from hematological malignancies represent a high prevalent subgroup of immunocompromised patients as the incidence of hematological malignancies has recently been evaluated in Europe to be about 230,000 new cases per year and are at increased risk of FG [6,7,8,9,10]. We performed an updated systematic review of the literature aimed at summarizing clinical presentation, treatment, and outcomes of FG in patients with oncohematological diseases

Results

Discussion

Conclusion