Concluded Case

Goodmorning Curofians. 39 year old male with 4 days history of pain, swelling and discolouration of penis and scrotum. No hx of trauma/operative procedure. Discussion is opened for management.

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A case of Fournier 's gangrene. Although D/D is fracture penis with extension of haematoma to scrotum . A colour doppler study with USG Scrotum urgently needed to rule out fracture penis. If no fracture penis, treat as an emergency for Fournier 's gangrene . Start IV line with fluids, parenteral antibiotics inj Piperacillin 4gm+ tazobactum 500 mg × 6 hourly for 7 days . Insert Foley's catheter. Shift to O.T and debridement indicated even if testis are exposed. Once debridement is complete if testis are exposed, testis may be implanted in a sub cutaneous pouch in upper medial thigh
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A case of Fournier 's gangrene. Although D/D is fracture penis with extension of haematoma to scrotum . A colour doppler study with USG Scrotum urgently needed to rule out fracture penis. If no fracture penis, treat as an emergency for Fournier 's gangrene . Start IV line with fluids, parenteral antibiotics inj Piperacillin 4gm+ tazobactum 500 mg × 6 hourly for 7 days . Insert Foley's catheter. Shift to O.T and debridement indicated even if testis are exposed. Once debridement is complete if testis are exposed, testis may be implanted in a sub cutaneous pouch in upper medial thigh
Sir kindly help with the antibiotics to use in various cases with suspected organisms @Dr. Parveen Yograj
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FOURNER'S GANGRENE Urgent USG & Colour Doppler CBC RFT LFT BLOOD SUGAR FASTING PP HIV urine routine Pus / tissue biopsy for culture Higher Antibiotics as per culture report Catherization SURGEON OPINION for debridement T bect ointment +co_mupiment ointment for dressing Plastic surgeon opinion for reconstruction
Suggestive of Fornier's gangrene, rule out DM or any immunosuppressive condition. Treatment would be broad spectrum parenteral antibiotics Wide excision of the slough and devitelised tissues.Allow the wound to granulate , secondary suturing or the skin grafting depending on the need.
FOURNIER'S GANGRENE ADVISABLE... 1. BLOOD AND. URINE. CULTURE // SENSITIVITY 2. ROUTINE. INVESTIGATION 3. USG....... SCROTUM. AND. PELVIS COLOR. DOPPLER 4. PARENTERAL. MANAGEMENT 5. DEBRIDEMENT. AND. DRESSINGS
Fournier's gangrene, multiple incision and after washing with hydrogen peroxide and saline,sprinkle enzomac-cm granules and dress with bactigrass sachet.Give heavy antibiotic cefaperazone-sulbactum , linezolid and chymoral forte
IT'S A CASE OF.. FOURNIER'S GANGRENE.. NEED'S CLINICOPATHOLOGICALLY EVALUATION WITH.. BLOOD.. URINE ROUTINE.. USG STUDY SCROTUM.. COLOUR DOPLER STUDY.. EXPERTS OPINION..
Tnx
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Classical case of fourniers gangrene , Manage by broad spectrum antibiotics + catheterization + surgical debridement + strict glycemic control
Founiers gangrene debridement broadspectram antibiotics regular dressing
Fourneier's gangrene, Scrotal exploration and proceed.
Fournier's gangrene
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