gangrene of the scrotum
Introduction
Introduction to scrotum gangrene Gangreneofscrotum is a very serious and rare acute scrotal infectious disease with rapid onset, rapid development and serious illness. Scrotal gangrene can occur within 2 days or even 10 hours due to infections caused by bacterial invasion and scrotal embolization. If the diagnosis is not timely, improper treatment can endanger the patient's life. basic knowledge The proportion of the disease: the proportion of the male population in the disease, the proportion is 0.002% - 0.005% Susceptible people: male Mode of infection: non-infectious Complications: myocarditis, septic shock
Cause
Scrotal gangrene
(1) Causes of the disease
The disease is caused by a mixed infection of various bacteria such as cocci, bacilli, anaerobic bacteria, and an acute infection of the subcutaneous tissue of the scrotum. Common Gram-positive cocci are Staphylococcus aureus, hemolytic streptococcus, Streptococcus faecalis, etc. The blue-negative bacilli include Escherichia coli, Klebsiella, Proteus, etc. The anaerobic bacteria are mainly Bacteroides, and the rapid proliferation of various bacteria occurs in the superficial fascia, and the infection spreads along the fascia surface. Occlusive endarteritis of the subcutaneous tissue results in tissue necrosis.
(two) pathogenesis
Routes of pathogen invasion: Pathogens mainly invade through the following three pathways.
1 direct invasion by the skin of the scrotum, often secondary to injury or infection of the scrotal skin;
2 urinary tract infection (mainly infection of glands around the urethra) develops to the periphery, piercing the fascia of the Buck and following the Darto fascia of the penis sac, and spreading the Scarpa fascia of the abdominal wall;
3 perianal abscess spread to the surrounding or retroperitoneal infection along the fascia of the penis scrotum, diabetes, cirrhosis, malnutrition, etc. are the predisposing factors of this disease.
Prevention
Scrotal gangrene prevention
1. Develop good habits to play an important role in the prevention and treatment of diseases. The underwear should be loose. Choose a cotton fabric with strong hygroscopicity and tight underwear and jeans without chemical fiber.
2. Improve the working environment, and do a good job of ventilation and cooling. Drivers driving long-distance buses should change their driving on time.
3. Eat less spicy food and eat more fresh vegetables and fruits. Choose a high-nutrition diet and add vitamin B2 or vitamin B.
Complication
Scrotal gangrene complications Complications, myocarditis, septic shock
Can be combined with toxic myocarditis and septic shock.
Symptom
Symptoms of scrotal gangrene common symptoms scrotum on white sputum skin necrosis tissue necrosis chills high fever severe pain shock
The disease occurs at any age, the onset is rapid, often at night, the patient is awakened by severe pain, the initial lesions are red and swollen, severe pain, scrotal skin and subcutaneous tissue necrosis in hours to days, pain after skin necrosis often Relieve, this may be related to the destruction of peripheral nerves. The lesions are often confined to the scrotum, the skin of the penis and the subcutaneous tissue. In severe cases, it can spread to the underarms and reach the depth of the scrotum. Due to the barrier function of the tunica, the testes are generally not affected. In the early stage of physical examination, local redness and strong tenderness can be seen. Sometimes the sputum can be heard under the skin. As the disease progresses, the scrotal skin appears flaky necrotic area, which is black, with serous exudation, further develops into pus, and the main symptoms are It is characterized by high fever, chills and other symptoms of toxic shock, which can lead to death if not treated in time.
Examine
Scrotal gangrene examination
1. Blood routine examination: The white blood cells in the blood increase significantly, and the nuclear shifts to the left.
2. Wound secretion culture: more than two pathogenic bacteria can be cultured.
3. ESR, C-reactive protein: ESR is increased due to obvious infection, and C-reactive protein is significantly increased.
Diagnosis
Diagnosis and identification of scrotal gangrene
diagnosis
According to the typical clinical manifestations, it is not difficult to diagnose the disease. The key is to recognize the acute onset of the disease, the rapid occurrence of scrotal necrosis and the symptoms of systemic poisoning. In the diagnosis, attention should be paid to the detection of urethral stricture infection, perianal infection and other primary diseases. Infected foci.
Differential diagnosis
Mainly with the scrotum acute cellulitis, scrotal erysipelas and scrotal elephant skin swelling, early identification is often not easy, but when the scrotum skin is purple-black, or even necrosis, causing testicular spermatic cord naked, it is not difficult to identify.
