RESUMO
INTRODUCTION: This work aims to describe and discuss the epidemiological, clinical, therapeutic and evolution of Fournier's gangrene. MATERIALS AND METHODS: Case series with retrospective data collection of patients treated for Fournier's gangrene between January 2010 and March 2017. The main etiologies, risk factors, postoperative complications outcomes and long term follow up results were analyzed. RESULTS: Eight four (84) patients were recruited. The average age of our patients was 49 years (with limits of 20-76), the male gender dominates our series (83.33%) with a sex ratio of 5 M/1W, the most frequently found risk factor was diabetes mellitus (37%). The most common etiology was anal abscesses (32%). The average time to consultation was 8 days (limits ranges from 3 to 30 days). All patients were admitted at a necrosis stage (100%). Anemia was identified in 85% of cases. The low platelets were noticed in 44.03% of cases. Hypoalbuminemia was found in 93% of cases. All patients (100%) benefited resuscitation initially and antibiotic therapy on their admission. They received emergency surgical debridement with a cleansing stoma. The average length of hospital stay was 13 days and complications occurred in 33% of cases. The mortality rate was 7.14%. CONCLUSION: Fournier's gangrene is a medico-surgical emergency with a high morbidity and mortality rate. Early diagnosis as well as antibiotic therapy and the quality of debridement save the patients.
RESUMO
Streptococcus pneumoniae (S. pneumoniae) colonizes asymptomatically the human nasopharynx. This pathogen is responsible for sinusitis, otitis media, pneumonia, bacteremia and meningitis. We report the case of a 35-year-old female patient who developed a surgical wound infection by a multi drug resistant S. pneumoniae serotype 19A after a total coloprotectomy. This first found in Morocco shows the implication of multidrug resistant S. pneumoniae in surgical wound infections.