RELATO DE CASO: SÍNDROME DE FOURNIER EM UM PACIENTE JOVEM SEM FATORES DE RISCOS

Abstract

This article is a case study on Fournier Syndrome (FS) in a young patient, 24 years old, with no previous comorbidities and no risk factors. The work was based on interviews with the patient and analysis of hospital records. Four databases were searched and fourteen articles were selected to support the study. FS is a rare and serious condition characterized by a necrotizing infection that mainly affects the perineal region, it was first documented in 1764 and since then its mortality rate has remained high, around 27%. The infection is caused by gram-positive, gram-negative and anaerobic microorganisms, the main isolated agents being: Escherichia coli, Pseudomonas aeruginosa, Enterococcus faecium and Staphylococcus aureus. It starts with cellulitis, triggering an exacerbated inflammatory response that results in tissue necrosis. Although the patient had no associated comorbidities, the presence of other conditions, such as diabetes mellitus, advanced age and immunosuppression, can accelerate the progression of the infection. Initial symptoms, such as pain, local erythema and fever, are nonspecific and can be confused with less serious infections. Initial misdiagnosis is common, which can lead to delays in proper treatment. Recognition is essentially clinical, but laboratory and imaging tests can help. The approach consists of early and aggressive surgical debridement of necrotic tissues, in addition to broad-spectrum parenteral antibiotic therapy. Hyperbaric oxygen therapy can also be used as an adjunctive treatment. FS represents a urological emergency, it is important that health professionals are familiar with this condition to enable an early diagnosis and adequate treatment, therefore, the implementation of specific protocols is essential to improve the quality of care provided to patients with FS.