Localized Fournier's Gangrene in "End-Stage" Renal Failure: Multidisciplinary Approach and Integration of Palliative Care.

Case Reports in Nephrology Pub Date : 2020-11-24 eCollection Date: 2020-01-01 DOI:10.1155/2020/8868993
M Voordeckers, J Noels, M Brognet, M T Salaouatchi, M Mesquita
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引用次数: 1

Abstract

Presentation of the Case. Penile gangrene is a rare entity with significant morbidity and mortality. There are only few case reports of isolated penile Fournier's gangrene in literature. Its rare occurrence, associated with complex and serious comorbidity, poses a major challenge to the attending medical personnel. A 53-year-old Caucasian patient with poorly controlled diabetes, progressive renal insufficiency, and multiple vascular complications presented with progressive necrosis of the penis (localized Fournier's gangrene). Discussion. Fournier's gangrene or necrotizing fasciitis refers to any synergistic necrotizing infection of the external genitalia or perineum and is a hallmark of severe systemic vascular disease. Fournier's gangrene is an absolute emergency because the time interval between diagnosis and treatment significantly influences morbidity and mortality. Despite aggressive management, the estimated mortality rates range from 57 to 71%. Conclusions. Improved integration of palliative care services into the care of such patients is important to improve end-of-life care even though they do not have a malignant disease. The "Palliative Care Indicator Tool" can help identifying people at risk of deteriorating health and is important to improve end-of-life care.

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终末期肾衰竭的局部富尼耶坏疽:多学科方法和姑息治疗的整合。
案例陈述。阴茎坏疽是一种罕见的疾病,发病率和死亡率都很高。文献中关于孤立性阴茎富尼耶坏疽的报道很少。其罕见的发生,并伴有复杂和严重的合并症,对医护人员提出了重大挑战。一例53岁白人糖尿病患者,伴有进行性肾功能不全和多种血管并发症,表现为进行性阴茎坏死(局限性富尼耶坏疽)。讨论。富尼耶坏疽或坏死性筋膜炎是指外生殖器或会阴的任何协同坏死性感染,是严重全身性血管疾病的标志。富尼耶坏疽是一个绝对的紧急情况,因为诊断和治疗之间的时间间隔显著影响发病率和死亡率。尽管进行了积极的治疗,估计死亡率仍在57%至71%之间。结论。将姑息治疗服务更好地纳入这类患者的护理,对于改善临终护理非常重要,即使他们没有恶性疾病。“姑息治疗指标工具”可以帮助确定面临健康恶化风险的人,对改善临终关怀非常重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Case Reports in Nephrology
Case Reports in Nephrology Medicine-Nephrology
CiteScore
1.70
自引率
0.00%
发文量
32
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