If you find that * * * has swelling and pain, don't ignore it, lest it be caused by Fornier's necrosis. Qiu, a urologist at Chi Mei Hospital, said that Vernier's necrosis is a kind of necrotizing fasciitis, which is caused by sudden soft tissue necrosis and infection such as skin injury and urinary tract bacterial infection. It will cause ulcers and even necrosis of the skin and subcutaneous soft tissue around the society and genitals. The high-risk groups are obvious trauma, weak body, low immunity or the elderly.
Press the abnormal part of the old man's skin and make a bang.
Clinically, an 83-year-old Mr. Zeng, who has been bedridden for a long time, is a patient with stage II liver cancer. He was rushed to the emergency department because of fever, dyspnea and hypotension. After examination, it was found that the patient's left abdominal wall was swollen and the epidermis was reddish. When you press an abnormal skin color with your finger, it will make a sound. Although the blood test showed that the white blood cell count was normal, the C-reactive protein representing acute inflammation in the body rose to 317.5 mg/L.
The disease progressed rapidly and bacteria invaded the chest all the way.
In addition, CT scan also showed that the subcutaneous tissue of the patient, including abdomen, bilateral scrotum and bilateral lower abdomen, was invaded by bacteria and even spread to the chest; Dr. Qiu pointed out that although the patient was arranged to undergo extensive surgery to remove necrotic tissue, his family was too old to want the patient to undergo surgery again, so they only agreed to take antibiotics. Mr. Zeng died after four days in hospital.
The initial symptoms are like cellulitis and the epidermis is red and swollen.
The doctor further explained that this case is a typical Fournier necrosis. Although the patient's epidermis is red and swollen at first, similar to cellulitis, the infection continues to invade, and fever or intense pain will occur.
Especially when bacteria invade to a certain extent, when you press the epidermis of the affected area with your fingers, you can hear a thumping sound like when you press bubble paper, which is also called twisting sound in clinic, indicating that the subcutaneous tissue has begun to die. At this time, because the subcutaneous space is full of gas, the pressure of gas makes the subcutaneous tissue easier to separate and bacteria easier to invade.
If you have unexpected symptoms, you should seek medical advice as soon as possible.
According to the literature, many kinds of bacteria usually invade Fournier's necrosis. Therefore, in addition to antibiotics, necrotic tissue must be removed by surgery, and debridement surgery must be repeated several times until it is confirmed that no new bacteria have invaded.
Dr. Qiu reminded that the course of this disease is very fast and the mortality rate is close to 80%. Therefore, if the body has unexpected or rapidly changing symptoms, it is necessary to be vigilant and seek medical treatment as soon as possible so as not to delay the golden treatment period.
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