Gangrena de Fournier: revisão sobre o diagnóstico e a fisiopatologia
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Resumo
Objetivo: Descrever a fisiopatologia e o diagnóstico da Gangrena de Fournier (GF). Revisão bibliográfica: Os pacientes com GF, geralmente, desenvolvem infecções de tecidos moles do escroto, regiões perineal e perianal, frequentemente, acompanhadas de edema, eritema, crepitação ou necrose. O fator de risco mais frequente é o Diabetes Mellitus (DM) com uma chance de desenvolver GF três vezes maior. O diagnóstico se dá, principalmente, pela história clínica e exame físico apropriado. Não há exames laboratoriais ou de imagem específicos para o diagnóstico da GF. O tratamento do paciente com GF envolve, essencialmente, a ressuscitação volêmica, a antibioticoterapia de amplo espectro e o desbridamento cirúrgico. Considerações finais: A GF é uma fasciite necrosante rara das regiões perineal, genital ou perianal e que necessita de rápido diagnóstico e tratamento, visto que pode evoluir rapidamente para disfunção de múltiplos órgãos e morte. A apresentação clínica é complexa podendo alterar-se dependendo da progressão da infecção e de características clínicas do paciente. Desse modo, a coleta de uma boa história clínica, a realização de um adequado exame físico e o entendimento da fisiopatologia da doença são fundamentais para o diagnóstico e tratamento precoces, podendo atenuar, assim, a alta taxa de letalidade desta doença.
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