血液透析病人發生福耳尼埃氏壞疽之個案報告及文獻回顧

Fournier's Gangrene in Patients with End-Stage Renal Disease: A Case Report And Literature Review

朱椰雯(Ya-Wun Chu) ； 江銘彥(Ming-Yan Jiang) ； 黃志強(Jyh-Chang Hwang)

《腎臟與透析》 29卷2期 (2017/06) Pp. 97-100

https://doi.org/10.6340/KD.2017.29(2).11

摘要

福耳尼埃氏壞疽 (Fournier's gangrene) 是一種生殖會陰部及肛門周邊快速進展之壞死性感染，造成覆蓋之皮膚壞疽，其病程往往具有高度的致命性，所以對此疾病性質及其治療原則的了解相當重要。這種感染易發生於免疫低下的人，例如糖尿病、腎衰竭、肝硬化等。在處理這個疾病時，需給予廣效抗生素及積極的外科清創手術，直到感染的情況被控制住。福耳尼埃氏壞疽患者的死亡率很高，若病人是腎衰竭患者，其死亡率更高。我們報告一個末期腎病的血液透析病人，發生了福耳尼埃氏壞疽，最後導致病人死亡。

關鍵字

福耳尼埃氏壞疽 ； 慢性腎衰竭 ； 末期腎病 ； 透析

並列摘要

Fournier's gangrene can present subtly and have devastating consequences if not discovered at an early stage. Primary care providers must be aware of this fulminant, necrotizing, albeit rare, infection that affects the perineal, genital, and perianal regions, as it can be mistaken for other common benign conditions but can progress rapidly to multiorgan dysfunction and death if missed. A high degree of suspicion should be maintained in those with risk factors such as diabetes mellitus, renal failure, and cirrhosis. Surgical debridement is the mainstay of treatment, along with early use of broad-spectrum antibiotics. Nonetheless, the mortality rate continues to be high. The mortality rate is even higher in patients with renal failure. We reported a case of end stage renal disease with hemodialysis treatment, who developed Fournier’s gangrene. Finally, this patient died unexpectedly.

並列關鍵字

Fournier's gangrene ； chronic renal failure ； end stage renal disease ； dialysis