糖尿病に合併したFournier's gangreneの1例と本邦報告例28症例の検討

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A case of Fournier's gangrene associated with diabetes mellitus was reported. The patient was 60-yr-old male. He suffered from advanced cerebral infarctions after resuscitation of long term severe hypotension secondary to myocardial infarction. His blood glucose level on admission showed 222 mg/dl. He developed sacral decubital ulcer which gave rise purulent infection to perineum, scrotum and right groin region. Causative organisms were Proteus mirabilis, Pseudomonas aeruginosa, E. coli, E. faecalis and coagulase negative staphylococcus. The gangrene was treated by repeated debridements and broad spectrum antibiotics. Twenty-eight cases of genitoperineal gangrene associated with diabetes mellitus reported in Japan for past 10 years were reviewed. The patiens were 24 males and 4 females. Average age of patients was 56.1 years. Average duration of diabetes mellitus of patients was 11.5 years. Mean blood glucose and HbA_1c were 410 mg/dl and 10.5%, respectively. Main causative organisms were E. coli, Bacteroides, Staphylococci, Steptococci, Klebsiella, Clostridium, Pseudomanas aeruginosa, Morganella, Proteus and Candida. They showed synergistic infections by several organisms. The gangrene spread to buttocks, thighs, prostate and other near organs. Main complications were sepsis, diabetic ketosis and ketoacidosis, alcoholic liver cirrhosis, heavy drinking, chronic renal failure and cerebral infarction. Four patients were deceased by septic shock, circulatory failure and renal failure.
香川県立保健医療大学の論文

糖尿病に合併したFournier's gangreneの1例と本邦報告例28症例の検討

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