KNR closely collaborated and supported the study, helped in preparation of manuscript discussed and critically analyzed the non operative management of patients in grand rounds on day to day basis. All authors read and approved the final manuscript.”
“Introduction Fournier’s gangrene (FG)

is a rare, rapidly progressive, fulminant form of necrotizing fasciitis of the genital, perianal and perineal regions, which may extend up to the abdominal wall between the fascial planes [1]. It is secondary to polymicrobial infection by aerobic and anaerobic bacteria with a synergistic action [2–4]. The cause of infection is identifiable in 95% of cases, mainly arising from anorectal, genito-urinary and cutaneous sources [5]. Predisposing factors such as diabetes and Immunosuppression lead to vascular disease and suppressed immunity that increase AZD8931 order susceptibility selleck to polymicrobial Infection. Diagnosis is based on clinical signs and physical examination. Radiological methods may help to delineate the extent of the disease but false negatives may happen. Dissemination of the disease was found to be a major determinant of patients’ outcomes in previous reports [6, 7]. It may reflect the aggressiveness of the involved infectious agents or reflects the degree of patients’ immunosuppression. Several reports tried to evaluate the usefulness of diverse scoring systems. Fournier’s Gangrene Severity Index (FGSI) has

become a standard for researchers, being routinely published in FG literature and is considered as a good predicting tool [8, 9]. PLEKHB2 The mortality rate for FG is still high, at 20–50% in most contemporary series [10, 11]. Fortunately, it is a rare condition, with a reported incidence of 1.6/100,000 males with peak incidence in the 5th and 6th decades. However, the incidence is rising, most likely due to an increase in the mean age of the population, as well as increased numbers of patients on immunosuppressive therapy or suffering from human immunodeficiency virus (HIV) infection, especially in Africa [12, 13]. Early diagnosis, aggressive resuscitation

of the patient, administration of broad-spectrum antibiotics and aggressive radical surgical debridement(s), are the key of successful treatment. In this study, we aimed to investigate patients with FG and to identify risk factors that affect mortality. Materials and methods The medical records of 50 consecutive patients admitted to the University Hospital Epacadostat manufacturer Hassan II of Fez, Morocco, General Surgery Department, with a diagnosis of Fournier’s gangrene during the 7-year period between January 2003 and December 2009 were retrospectively reviewed. The inclusion criteria included patients undergoing wide surgical excision of scrotal and/or perineal necrosis along with other involved areas with a postoperative diagnosis of Fournier’s gangrene. Excluded were patients who had a local superficial inflammation of the perianal or urogenital regions as they were treated in Urology Department.