Bakalli I, Heta S, Kola E, Celaj E. Fournier gangrene in an infant, complicated with severe sepsis and liver dysfunction: A case report. World J Clin Cases 2023; 11(30): 7398-7402 [PMID: 37969457 DOI: 10.12998/wjcc.v11.i30.7398]
Corresponding Author of This Article
Ilirjana Bakalli, PhD, Associate Professor, Department of Pediatrics, UHC “Mother Theresa”, Rruga e Dibres, 376, Tirana 1024, Albania. ilirjanabakalli@yahoo.com
Research Domain of This Article
Pediatrics
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Ilirjana Bakalli, Ermira Kola, Ermela Celaj, Department of Pediatrics, UHC “Mother Theresa”, Tirana 1024, Albania
Saimir Heta, Department of Pediatric Surgery, UHC “Mother Theresa”, Tirana 1024, Albania
Author contributions: Bakalli I conceptualized, supervised data collection, drafted the initial manuscript, and corrected the final English version; Heta S and Celaj E contributed to the acquisition of data; Kola E revised the manuscript; and all authors have read and approved the manuscript critically.
Informed consent statement: The present manuscript used anonymous images to produce its analyzes and results, in a method that obeys the norms of medical bioethics. Thus, there was no direct or even indirect contact between researchers and patients, with no necessity for “Signed Informed Consent Form” to carry out our study.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ilirjana Bakalli, PhD, Associate Professor, Department of Pediatrics, UHC “Mother Theresa”, Rruga e Dibres, 376, Tirana 1024, Albania. ilirjanabakalli@yahoo.com
Received: July 2, 2023 Peer-review started: July 2, 2023 First decision: July 28, 2023 Revised: August 9, 2023 Accepted: September 6, 2023 Article in press: September 6, 2023 Published online: October 26, 2023 Processing time: 114 Days and 10.9 Hours
Abstract
BACKGROUND
Fournier gangrene is a rare, life-threatening infection characterized by necrotizing fasciitis in the perineal, genital and/or lower abdominal regions. Despite its rarity, the unfavorable prognosis associated with this disease is dependent on the timing of medical care.
CASE SUMMARY
A 3-month-old boy was admitted to our pediatric intensive care unit in critical condition after a 5-day history of fever and scrotal erythema with breaching skin lesions and swelling. Despite ambulatory antibiotic treatment, the child’s clinical condition deteriorated. At the time of admission, the child had necrotizing scrotal fasciitis that had spread to the abdomen. Following reanimation, the surgeon decided on an immediate intervention to rule out testicular torsion and to debride the affected area. Despite optimal antibiotic and supportive therapy, the patient developed severe sepsis with liver dysfunction, making treatment more challenging.
CONCLUSION
Recognizing Fournier gangrene, prompt referral to pediatric surgery, and appropriate antibiotic coverage are critical for avoiding sepsis and multiorgan dysfunction.
Core Tip: This is a case report of an infant with Fournier gangrene. Despite its rarity, Fournier gangrene remains a disease with severe complications and high mortality. The prognosis is influenced by the timing of medical treatment. Despite receiving optimal antibiotic and supportive care after hospital admission, the patient developed sepsis with severe liver damage, making treatment more challenging. The prognosis to sepsis and liver dysfunction was influenced by delayed diagnosis. Through this case report we highlight the importance of early recognition and high clinical suspicion by all doctors (pediatricians, dermatologist, surgeons, etc.), to make an accurate diagnosis.
