フルニエ症候群

Fournier's Syndrome

要旨　フルニエ症候群は，感染の炎症が筋膜に沿って広範囲に波及する“感染性壊死性筋膜炎"であり，致死率が高く，緊急外科処置を必要とする．CT検査で診断し，速やかに外科治療を開始する．合併症として糖尿病，直腸癌に注意する．手術は，壊死部を含む感染巣の除去と切開排膿，ドレナージを行い，必要に応じて人工肛門を造設する．抗菌薬は，嫌気性，好気性菌の両方に感受性のあるものを使用する．治療が遅れると救命率は低下する．

　Fournier's gangrene is‘an infective necrotizing fasciitis'which means that infective inflammation spreads widely along the fascia. It is fatal and needs urgent surgical treatment. It is diagnosed by CT study and surgical treatment should be started as soon as possible. Diabetes mellitus and rectal cancer are important as comorbidity entities. Surgical treatment consists of extensive debridement of damaged and necrotic tissue, incision and drainage. Colostomy is created if necessary. Intravenous antibiotics sensitive for both anaerobic and aerobic bacteria should be administered. Delay in surgical treatment is the cause of lethal outcome.