Management of Fournier's gangrene at the Kenyatta National Hospital, Nairobi.

A prospective study involving the management of forty six patients with Fournier's gangrene was carried out at the Kenyatta National Hospital, Nairobi over a period of two years. The age range was nine to 81 years with a mean of 40.27 years indicating that the lesion is common and affects all age groups in this locality. The majority of patients (60.86%) presented with advanced lesions involving scrotal ulcers (45.65%) and gangrene (15.22%). Results of bacterial culture from scrotal wound swabs isolated multiple organisms in 8.15% of the patients, a point which should be taken into consideration during antibiotic selection. Forty one patients (89.13%) had surgical procedures in addition to antibiotics and other supportive measures. Five other patients (10.87%) who presented with early lesions had medical treatment only with antibiotics, antipyretics and analgesics. The average duration of hospitalisation was sixteen days. Two patients (4.35%) one of whom was HIV positive died from septicaemia during the study period. Recurrent scrotal infection occurred in two patients (4.35%) after discharge from the hospital and were treated satisfactorily at the surgical outpatient clinic.