Fournier's gangrene in Bujumbura: epidemiology, etiological factors, treatment and prognostic

Abstract

Aim: To determine the epidemiological, etiological, therapeutic and evolutionary aspects of Fournier's gangrene (FG). Patients and methods: It was a retrospective and descriptive study of 10 patients who were treated in four main public hospitals in Bujumbura for Fournier's Gangrene. It covers a period of two years. Results: The frequency of FG was 0.102%. The Mean age was 46.7 years. In our series, all patients were male. Six out of 10 patients consulted between 5 and 15 days after the onset of signs. Urogenital antecedents predominate (40%). Diabetes is the predominant predisposing factor (40%), paraplegia (20%) and HIV (10%). Secondary Fournier's gangrene represents 70% of which 4 cases of urogenital causes, 2 of skin causes and 1 case of proctological cause. The lesions were limited to the perineum in 80% of the patients. Bacteriological examination essentially found Escherichia coli (70%). The average ISGF was 10,5 (20%) in patients who died (2 cases). The association of antibiotics combining cephalosporin, aminoglycoside and imidazole predominated prescription (60%). The debridement was the essential surgical treatment (90%). Urinary diversion has been in 100%. An average stay of 93.6 days. Complications were septic shock (20%), renal failure (40%) and anemia (20%). Conclusion: Fournier's gangrene remains a relatively rare pathology in our hospitals. Late consultation explains the delay in diagnosis. The etiologies are dominated by urogenital causes with diabetes as the main risk factor. Early consultation and control of enabling factors would reduce the mortality rate