We present two patients of TA who presented with gangrene of extremities, and review eight prior such patients reported in the literature. [ncbi.nlm.nih.gov]

Presentation Gangrene can affect any part of the body but most often affects the extremities, ie the fingers and toes. Gangrene can also affect the internal body organs, particularly the gastrointestinal tract. [patient.info]

• Weakness

  Weak immune system If your immune system is seriously weakened, minor infections can become more serious and can lead to gangrene. [nhs.uk]

  You may have a fast heartbeat and feel weak or dizzy. If the infection spreads, you may be confused or lose consciousness. How is gangrene diagnosed and treated? Your healthcare provider will examine the area and take a sample of tissue. [drugs.com]

  Risk Factors Things that raise the risk are: Having health problems that affect blood flow, such as diabetes or peripheral artery disease Trauma Surgery Burns Dog bites Frostbite Obesity A weak immune system Symptoms Symptoms start slow and then get worse [winchesterhospital.org]

• Intravenous Drugs

  The route of entry usually follows trauma, including surgery and intravenous drug (ab)use. M proteins produced by GAS allow the bacteria to adhere to tissue and evade the immune system. [dermnetnz.org]

  Herein we present a case of gas gangrene of the arm in an intravenous drug user with a history of intramuscular injections with normal saline in the shoulder used to provoke pain for recovery after drug induced coma. [wjes.biomedcentral.com]

  drug use Rarely, gangrene is linked to use of the anticoagulant drug, warfarin. [medicalnewstoday.com]

• Gangrene of the Toe

  This foot shows dry gangrene of the toe. Gangrene is a type of necrosis (the premature death of cells in living tissue) caused by insufficient blood supply. [ucl.ac.uk]

  […] and toes of a child with Raynaud's disease Wellcome L0062236.jpg 5.464x4.724; 3,27 MB Feet and toes of a child with Raynaud's disease Wellcome L0062237.jpg 4.664x5.812; 4,42 MB Foot affected by gangrene, showing the sole. [commons.wikimedia.org]

  We present a case of fulminant gangrene of fingers, toes, and nose in a 77-year-old woman with atypical pneumonia and acute renal failure. [scielo.br]

• Pallor

  Indicators of vascular insufficiency include pallor upon elevation of the limb and rubor upon dependency, along with ... [accessmedicine.mhmedical.com]

  Tachycardia Hypotension Tachypnoea Symptoms/signs relating to area of involvement Wet gangrene Swelling Erythema in early stages Pain Discharge - may be frank pus Foul-smelling odour The area becomes black Dry gangrene Erythema may be present Coldness and pallor [patient.info]

  […] and is named after a French venereologist, Jean Alfred Fournier, following five cases he presented in clinical lectures in 1883.[2] Signs and symptoms[edit] Initial symptoms of Fournier gangrene include swelling or sudden pain in the scrotum, fever, pallor [en.wikipedia.org]

  Pallor, sweating, and rapid (or "racing") heartbeat. [emedicinehealth.com]

• Raynaud Syndrome

  […] disease with gangrene Raynauds disease w gangrene Raynauds disease with gangrene Raynauds syndrome w gangrene Raynauds syndrome with gangrene Secondary diabetes with gangrene Secondary DM w diabetic gangrene Secondary Raynaud phenomenon with gangrene [icd9data.com]

  [1] The feet and hands are most commonly affected.[1] Certain types may present with a fever or sepsis.[1] Risk factors include diabetes, peripheral arterial disease, smoking, major trauma, alcoholism, HIV/AIDS, frostbite, and Raynaud's syndrome.[3][ [en.wikipedia.org]

• Respiratory Distress

  These include stroke, cerebrovascular accident, tension ascites, ovarian torsion, adult respiratory distress syndrome, venous and arterial thromboembolism, peripheral gangrene, hypercoagulation, and serious impairment of liver or renal function. [dictionary.cambridge.org]

  (Include acute renal failure and adult respiratory distress syndrome). After recovering from a threatening condition, large scrotal, perineal, penile, and abdominal wall skin defects may require reconstructive procedures. [intechopen.com]

  A state of altered consciousness and respiratory distress at initial presentation were found to be statistically significant factors for eventual mortality. [emedicine.medscape.com]

• Loss of Appetite

  If the area is infected, you may also have other signs related to the underlying infection, such as: a high temperature of 38C or above feeling hot and shivery loss of appetite rapid heartbeat and breathing dizziness Without treatment the affected tissue [nhs.uk]

  Fever Loss of appetite Tachycardia Hypotension Tachypnoea Symptoms/signs relating to area of involvement Wet gangrene Swelling Erythema in early stages Pain Discharge - may be frank pus Foul-smelling odour The area becomes black Dry gangrene Erythema [patient.info]

  Gastritis and an ulcer are conditions that affect the stomach and small intestine, and they share many symptoms, such as abdominal pain, nausea, vomiting, loss of appetite and weight loss. There are many differences, though. [tmphysiciannetwork.org]

  The most common symptoms include: Nausea Abdominal bloating Vomiting Indigestion Hiccups Loss of appetite Vomiting blood or coffee ground-like material Black, tarry stool Get useful, helpful and relevant health + wellness information enews More health [my.clevelandclinic.org]

• Vascular Disease

  […] diabetes with gangrene Secondary DM w diabetic gangrene Secondary Raynaud phenomenon with gangrene Tissue necrosis in peripheral vascular disease Tissue necrosis w gangrene in peripheral vascular disease Clinical Information Death and decay of body tissue [icd9data.com]

  This is one of the most common types of gangrene, and it occurs when there is a lack of blood flow to an extremity due to vascular disease (including vascular disease, diabetes, or frostbite). [verywellhealth.com]

  disease) 죽종(atheroma) 동맥성 변성(arterial degeneratio) 동맥혈관성 변성(arteriovascular degeneratio) 혈관성 변성(vascular degeneratio) 변형성 또는 폐색성 동맥내막염(endarteritis deformans or obliterans) 노인성 동맥염(senile arteritis) 노인성 동맥내막염(senile endarteritis) 제외：대뇌(cerebral)(I67.2 [dic.impact.pe.kr]

  BACKGROUND: Bilateral and simultaneous lower extremity amputations unrelated to diabetes and peripheral vascular disease are uncommon, although they may be necessary in patients with severe blast injuries. [ncbi.nlm.nih.gov]

  It develops when the blood supply to an affected body part is cut off because of various factors such as infection, vascular disease, or trauma. [medbroadcast.com]

• Tachycardia

  Her heart rate may increase (tachycardia), along with rapid breathing, sweating, paleness, and fever. [healthychildren.org]

  Fever Loss of appetite Tachycardia Hypotension Tachypnoea Symptoms/signs relating to area of involvement Wet gangrene Swelling Erythema in early stages Pain Discharge - may be frank pus Foul-smelling odour The area becomes black Dry gangrene Erythema [patient.info]

  Severe dehydration—which is an emergency—can cause extreme thirst, extreme sleepiness, sunken fontanels, and fussiness in infants; irritability/confusion in adults; and dry mucous membranes, little urine to anuria, sunken eyes, tenting, hypotension, tachycardia [contemporaryclinic.pharmacytimes.com]

  Systemic findings in Fournier gangrene may include leukocytosis, dehydration, tachycardia, thrombocytopenia, anemia, hypocalcemia, and hyperglycemia (, 7,, 8,, 16 ). [dx.doi.org]

• Skin Disease

  disease, the treatment of which is mostly empirical. [dx.doi.org]

  Institute of Arthritis and Musculoskeletal and Skin Diseases Information Clearinghouse One AMS Circle Bethesda, MD 20892-3675 USA Phone: (301) 495-4484 Toll-free: (877) 226-4267 Email: [email protected] Website: http://www.niams.nih.gov/ NIH/National [rarediseases.org]

  diseases See the DermNet NZ bookstore. [dermnetnz.org]

  The overlying skin may appear shiny and tense.[8] Other signs which are more suggestive of necrotizing changes (but present in later stages in 7 to 44% of the cases) are: formation of bullae, bleeding into the skin which is present before skin necrosis [en.wikipedia.org]

• Dry Skin

  Watch for signs of dehydration, such as dry skin and a dry mouth, feeling lightheaded, and being really thirsty. Call your doctor if you have any of these symptoms. [webmd.com]

  It is very important to watch for signs of dehydration, which include: Extreme thirst Urine that is darker in color, or less in amount Dry skin Dry mouth Sunken cheeks or eyes In infants, dry diapers (for more than 4-6 hours) Get useful, helpful and relevant [my.clevelandclinic.org]

  Mild to moderate dehydration can cause dry mouth, fatigue, sleepiness, thirst, decreased urine output, dry skin, constipation, and dizziness. [contemporaryclinic.pharmacytimes.com]

  The most common symptoms of gangrene include: exceptionally dry skin (possibly peeling skin) skin color may change to blue, deep red, or greenish-black areas of bleeding underneath the skin numbness or tingling in and around the affected area swelling [verywellhealth.com]

• Dermatitis

  […] see also Ulcer, pressure) 707.00 Cellulitis (diffuse) (with lymphangitis) (see also Abscess) 682.9 gangrenous (see also Gangrene) 785.4 Decubital gangrene (see also Ulcer, pressure) 707.00 [ 785.4 ] Decubitus (ulcer) (see also Ulcer, pressure) 707.00 Dermatitis [icd9data.com]

  Gangrene B Blackleg (disease) C Chronic undermining burrowing ulcer D Dermatitis gangrenosa F Fournier gangrene G Gas gangrene N Necrotizing fasciitis Noma (disease) P Pyoderma gangrenosum T Trench foot Retrieved from "https://en.wikipedia.org/w/index.php [en.wikipedia.org]

  L08) A00-B99에 분류된 특이적 감염(specific infections classified to A00-B99) 정맥류성 궤양(varicose ulcer)(I83.0, I83.2) L98 달리 분류되지 않은 피부 및 피하조직의 기타 장애(Other disorders of skin and subcutaneous tissue, NEC) - L98.0 화농성 육아종(Pyogenic granuloma) L98.1 인공피부염(Factitial dermatitis [dic.impact.pe.kr]

• Flushing

  If the wound becomes seriously contaminated, visit your pediatrician or an emergency department, where they likely will flush it with water and start antibiotics such as penicillin or clindamycin. [healthychildren.org]

  Flush away any poo or vomit in the toilet and clean the surrounding area with a bleach-based household cleaner. Avoid eating raw, unwashed produce and only eat oysters from a reliable source, as oysters can carry norovirus. [nhsinform.scot]

• Skin Lesion

  Painful skin lesions typically occur one to two weeks after a surgery. Another name for this condition is progressive bacterial synergistic gangrene. Risk factors Things that can increase the risk of gangrene include: Diabetes. [mayoclinic.org]

  These antibodies are commonly of IgM type and agglutinate erythrocytes usually below a temperature of 32º C.1 The most frequent manifestations are skin lesions, mainly on the acral areas, with acrocyanosis and Raynaud's phenomenon.1,2 Livedo reticularis [scielo.br]

  This rare type of gangrene typically occurs after an operation, with painful skin lesions developing one to two weeks after surgery. Risk factors Several factors increase your risk of developing gangrene. These include: Diabetes. [nchmd.org]

• Dizziness

  If the area is infected, you may also have other signs related to the underlying infection, such as: a high temperature of 38C or above feeling hot and shivery loss of appetite rapid heartbeat and breathing dizziness Without treatment the affected tissue [nhs.uk]

  If the area is infected, you may also have other signs related to the underlying infection, such as: a high temperature (fever) loss of appetite rapid heartbeat and breathing dizziness shivering Without treatment the affected tissue will start to die. [nidirect.gov.uk]

  If there is an infection, symptoms will also include a high fever, dizziness, and loss of appetite as well as shivering and a rapid heartbeat. Who to See and Types of Treatments Available The effects of gangrene cannot be reversed. [docdoc.com.sg]

  You may have a fast heartbeat and feel weak or dizzy. If the infection spreads, you may be confused or lose consciousness. How is gangrene diagnosed and treated? Your healthcare provider will examine the area and take a sample of tissue. [drugs.com]

  Call 911 or go to the nearest emergency room if you experience the following symptoms: discoloration in a body part loss of feeling, often after severe pain foul-smelling discharge sores or blisters that bleed a high fever and chills dizziness rapid heartbeat [healthline.com]

Epidemiologic characteristics, clinical presentation, diagnostic workup, therapeutic options and morbidity-mortality rates of Fournier's gangrene are reviewed, emphasizing the role of immunosuppression in renal transplant recipients to disease development [ncbi.nlm.nih.gov]

(see Clinical and Workup). They require aggressive treatment to combat the associated high morbidity and mortality (see Treatment). Images of necrotizing fasciitis are shown below. [emedicine.medscape.com]

• Hyperglycemia

  Dry gangrene and diabetes Dry gangrene is the type of gangrene that can occur as a complication of a pre-existing health condition, including type 1 and type 2 diabetes As a result of damage to the blood vessels throughout the body due to prolonged hyperglycemia [diabetes.co.uk]

  Diabetics are always at a high risk of compromised skin integrity and impaired wound healing due to peripheral neuropathy, vascular insufficiency, and hyperglycemia. [dovepress.com]

  Systemic findings in Fournier gangrene may include leukocytosis, dehydration, tachycardia, thrombocytopenia, anemia, hypocalcemia, and hyperglycemia (, 7,, 8,, 16 ). [dx.doi.org]

  Laboratory studies The following studies are indicated in patients Fournier gangrene: CBC with differential count Electrolytes, BUN, creatinine, blood glucose levels: Acidosis with hyperglycemia or hypoglycemia may be present. [intechopen.com]

Treatments for gangrene are determined by the location and extent of the damage. Possible treatments include revascularization (the restoration of blood flow), antibiotics or amputation. [ucl.ac.uk]

treatment, or with no treatment. [cochrane.org]

[…] all dead tissue, however, is the mainstay of treatment for gangrene. [en.wikipedia.org]

If treatment is delayed, the gangrene is extensive, or the person has other significant medical problems, the person may die. [nlm.nih.gov]

Prognosis Prognosis depends on the presence of other morbidity, the area of the body affected and the extent of gangrene. One quarter of patients will develop septic shock which has a high fatality rate. [patient.info]

PURPOSE: For survivors of perineal gangrene (PG), quality of life and functional prognosis of pelvic functions are probably overestimated. [ncbi.nlm.nih.gov]

What is the prognosis for wet gangrene? Prognosis in wet gangrene depends on the extent of disease, the underlying cause and the timing of appropriate treatment. [dermnetnz.org]

Gas gangrene has the worst prognosis. It is associated with a high death rate because it causes the infection to quickly spread to the bloodstream. References: Lipworth AD, et al., eds. [docdoc.com.sg]

The second is a 40-year-old woman who consults for dry gangrene of hands and feet, without demonstrable etiology. [scielo.iics.una.py]

The usual etiology of hypernatremic dehydration in this age group is insufficient breast milk intake. [ncbi.nlm.nih.gov]

Colorectal etiology were the most frequent (n=18). The most common clinical presentation were perineum pain (n=21) and erythema (n=19). [scielo.org.co]

Trauma is the most common etiology. Nonpalpable pulses are common. Palpable pulses do not preclude the presence of limb-threatening ischemia. [accessmedicine.mhmedical.com]

Medical management of PAD involves comprehensive care, including risk factor modification of etiologies predisposing to atherosclerosis. [doi.org]

Epidemiologic characteristics, clinical presentation, diagnostic workup, therapeutic options and morbidity-mortality rates of Fournier's gangrene are reviewed, emphasizing the role of immunosuppression in renal transplant recipients to disease development [ncbi.nlm.nih.gov]

"Fournier's gangrene: Population based epidemiology and outcomes". The Journal of Urology. 181 (5): 2120–6. doi:10.1016/j.juro.2009.01.034. PMC 3042351. PMID 19286224. [en.wikipedia.org]

Epidemiological characteristics of Fournier's gangrene: a report of 71 patients. Urol Int. 2012;89:457-61. [ Links ] 10. Yilmazlar T, Ozturk E, Ozguc H, Ercan I, Vuruskan H, Oktay B. [scielo.br]

[…] presents as symmetrical gangrene of two or more extremities without large vessel obstruction or vasculitis. [ 2 ] Fournier's gangrene is a rare but severe necrotising fasciitis of the external genitalia. [ 3, 4 ] Other forms of necrotising fasciitis. [ 5 ] Epidemiology [patient.info]

2 TABLE 3: OTHER EPIDEMIOLOGIC CONSIDERATIONS2 Travel (in general) E. coli is the most common cause of traveler’s diarrhea. [contemporaryclinic.pharmacytimes.com]

Designed to provide students with essential concepts of disease processes and altered health states, this text is ideal for both discrete and integrated pathophysiology courses. [books.google.com]

Understanding pathophysiology (ấn bản 1). Chatswood, N.S.W.: Elsevier Australia. ISBN 0729539512. Liên kết ngoài[sửa | sửa mã nguồn] Life In The Fast Lane: toxicology Conundrum #018 Undersea and Hyperbaric Medical Society. [vi.wikipedia.org]

No classification scheme matches perfectly with the pathophysiology; a large degree of overlap exists. Some forms of gastritis involve acid-peptic and H. pylori disease (see also Overview of Acid Secretion). [merckmanuals.com]

The hallmarks of this disease are rapid onset of myonecrosis with muscle swelling, severe pain, gas production, and sepsis. [1, 2, 3] Pathophysiology Clostridium species are gram-positive, spore-forming, anaerobic rods normally found in soil and the gastrointestinal [emedicine.medscape.com]

Treatment for gangrene involves removing the affected tissue, preventing infection or treating any existing infection, and treating the problem that led to gangrene developing. [nhs.uk]

Prevention If you have risk factors for developing gangrene, there are steps you can take to prevent it. Being aware of the possibility of gangrene is an important aspect of prevention, particularly because gangrene doesn’t always cause pain. [verywellhealth.com]