Fournier's gangrene: our experience in 5 years, bibliographic review and assessment of the Fournier's gangrene severity index.

OBJECTIVES Fournier's gangrene is a devastating infection, which includes the genital, perineal and/or perianal regions. It is potentially fatal, and affects any age and gender. The severity index for Fournier's gangrene has been described; it is useful for evaluating the prognosis of these patients. Our goal is to report our experience with this disease over the past 5 years and evaluate the index in retrospect. METHODS We analyzed medical records of patients with Fournier gangrene over the last 5 years at the University Hospital "Dr. José E. González". RESULTS We reviewed 50 cases, male gender was predominant (96%), mean age 47.5 years, diabetes mellitus was found in 80%, neurogenic bladder in 10%, 2% HIV positive. The most frequent sites of origin of infection were scrotum (52%) and perineum (38%), the most common pathogen E. coli and Enterococcus faecalis (48 and 28% respectively). The death rate was 12%. The average severity index was 5.64. DISCUSSION In our hospital, Fournier's gangrene is rare. Nevertheless, there is a rapid diagnosis protocol and therapeutic management is performed immediately. Until now, the immediate surgical treatment and early initiation of antibiotic therapy remains the best therapeutic option. CONCLUSION There is a relationship between the index of severity and patient survival, which may become a useful parameter in evaluating these patients.