Perianal Infections in Patients With Hematologic Malignancy: The Risk of Fournier's Gangrene Leading to Mortality and Irreversible Organ Damage

Basit Öğe Kaydı
dc.authorscopusid15053759700
dc.contributor.authorSimsek A.
dc.date.accessioned2024-08-04T20:03:29Z
dc.date.available2024-08-04T20:03:29Z
dc.date.issued2022
dc.departmentİnönü Üniversitesien_US
dc.description.abstractINTRODUCTION: The efficacy of surgical intervention for perianal infection in patients with hematologic malignancy is not well-established. OBJECTIVE: This article presents a case series of perianal infection progressing to Fournier's gangrene (FG) in patients with hematologic malignancy to guide physicians, because to the author's knowledge, there were no randomized or prospective studies presenting the management strategies reported herein. It was hypothesized that surgery might reduce mortality and morbidity in patients with inflammation spreading beyond the perianal region, in patients with abscess formation, and in those who show no improvement with medical therapy. MATERIALS AND METHODS: The data of 4 adults with hematologic malignancy who developed perianal infection progressing to FG between January 2010 and December 2018 were reviewed retrospectively. Patients younger than 18 years and patients without hematologic malignancies or FG were excluded. The primary outcome was mortality. The secondary outcome was irreversible organ damage. RESULTS: Four male patients with a mean age of 36.75 years ± 13.1 standard deviation (range, 23-52 years) reported fever and dull anal pain during treatment for hematologic malignancy. A broad-spectrum antibiotic regimen was administered as initial empiric therapy at onset of fever and was de-escalated based on the culture results and clinical response. However, FG arose in all cases approximately 8.75 days ± 6.94 (range, 3-17 days) after onset of anal pain. All patients underwent surgical debridement, and diverting ostomy was performed in 3 cases. One patient died of overwhelming sepsis (25%), and 1 patient required orchiectomy (25%). CONCLUSIONS: Clinical suspicion of FG may be effective in reducing mortality in patients with hematologic malignancy, especially in cases with fever accompanied by anal pain. Surgical intervention may improve the prognosis for patients with inflammation spreading beyond the perianal region, patients with abscess formation, those who show no improvement in medical therapy, and those who develop FG. Diverting ostomy may improve survival in patients with FG.en_US
dc.identifier.endpage35en_US
dc.identifier.issn1943-2704
dc.identifier.issue1en_US
dc.identifier.pmid34928812en_US
dc.identifier.scopus2-s2.0-85122845518en_US
dc.identifier.scopusqualityQ1en_US
dc.identifier.startpage31en_US
dc.identifier.urihttps://hdl.handle.net/11616/91848
dc.identifier.volume34en_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherNLM (Medline)en_US
dc.relation.ispartofWounds : a compendium of clinical research and practiceen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectadulten_US
dc.subjectcomplicationen_US
dc.subjectdebridementen_US
dc.subjectFournier gangreneen_US
dc.subjecthematologic diseaseen_US
dc.subjecthumanen_US
dc.subjectmaleen_US
dc.subjectprospective studyen_US
dc.subjectretrospective studyen_US
dc.subjectAdulten_US
dc.subjectDebridementen_US
dc.subjectFournier Gangreneen_US
dc.subjectHematologic Neoplasmsen_US
dc.subjectHumansen_US
dc.subjectMaleen_US
dc.subjectProspective Studiesen_US
dc.subjectRetrospective Studiesen_US
dc.titlePerianal Infections in Patients With Hematologic Malignancy: The Risk of Fournier's Gangrene Leading to Mortality and Irreversible Organ Damageen_US
dc.typeArticleen_US

Dosyalar

Koleksiyon

Scopus İndeksli Yayınlar Koleksiyonu
PubMed İndeksli Yayın Koleksiyonu