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タイトル: | Fournier壊疽との鑑別に難渋した陰茎壊疽性膿皮症の1例 |
その他のタイトル: | A Case of Pyoderma Gangrenosum of the Penis Difficult to Distinguish from Fournier Gangrene |
著者: | 田口, 真 井上, 貴昭 西田, 晃久 川端, 和史 川喜多, 繁誠 六車, 光英 室田, 卓之 木下, 秀文 松田, 公志 |
著者名の別形: | Taguchi, Makoto Inoue, Takaaki Nishida, Teruhisa Kawabata, Takashi Kawakita, Shigenari Muguruma, Kouei Murota, Takashi Kinoshita, Hidefumi Matsuda, Tadashi |
キーワード: | Penile Fournier gangrene Pyoderma gangrenosum |
発行日: | 30-Nov-2015 |
出版者: | 泌尿器科紀要刊行会 |
誌名: | 泌尿器科紀要 |
巻: | 61 |
号: | 11 |
開始ページ: | 459 |
終了ページ: | 463 |
抄録: | Here, we report a case of pyoderma gangrenosum of the penis which was difficult to distinguish from Fournier gangrene. The patient was a 54-year-old male who was aware of redness and swelling of the glanspenis for 1month prior to a consultation at our department. Although he was diagnosed with herpes andtreated at a nearby hospital, his symptoms did not improve. Subsequently, the patient visited ourdepartment following the onset of pain and fever. During his initial consultation, he had a fever of 39°C as well as redness and swelling of the glans penis with partial spontaneous purulent discharge. His blood test revealed an elevated white blood cell count (20, 000/μl) and C-reactive protein (19.1 mg/dl). Because Fournier gangrene was suspected, administration of broad-spectrum antimicrobial agents was initiated butproved to be ineffective. An abscess (2 cm in diameter) was also noted in the umbilical region.Enterococcus faecalis was detected by the bacterial culture ; and therefore, Fournier gangrene was diagnosed. A partial penectomy was performed to control the infection. Pathological findings showed only non-specific inflammation ; however, fever persisted postoperatively and blood test results showed no improvement. Furthermore, new abscess lesions emerged on the right heel and back. Because the re-performed abscess bacterial culture test result was negative, pyoderma gangrenosum was suspected, and he was started on oral prednisolone (20 mg/day). On the following day, his fever subsided and his blood test results also showed improvement. A final diagnosis of pyoderma gangrenosum was ultimately made. |
著作権等: | 許諾条件により本文は2016/11/01に公開 |
URI: | http://hdl.handle.net/2433/202894 |
PubMed ID: | 26699892 |
出現コレクション: | Vol. 61 No. 11 |
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