Fournier’s gangrene secondary to marsupialization of Bartholin’s gland: a case report

Luis F. Ramirez; Maria I. Moyano; Diego F. Viteri; Leonardo A. Puente

doi:10.18203/2320-1770.ijrcog20250525

Authors

Luis F. Ramirez Department of Gynecology and Obstetrics, Axxis Hospital, International University of Ecuador; Quito, Ecuador https://orcid.org/0000-0001-5387-6127
Maria I. Moyano Department of Gynecology and Obstetrics, Axxis Hospital, International University of Ecuador; Quito, Ecuador https://orcid.org/0009-0000-6883-0885
Diego F. Viteri Department of General Surgery, Axxis Hospital, International University of Ecuador; Quito, Ecuador https://orcid.org/0009-0000-5689-3555
Leonardo A. Puente Department of Gynecology and Obstetrics, Axxis Hospital, International University of Ecuador; Quito, Ecuador https://orcid.org/0009-0002-7009-9483

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20250525

Keywords:

Fournier’s gangrene, Bartholin glands abscess, Marsupialization

Abstract

We present the case of a 38-year-old patient without risk factors, who presented with Fournier’s gangrene secondary to marsupialization of Bartholin´s gland. Fournier´s gangrene is an extremely rare complication after the instrumented management of Bartholin´s gland abscess. The case aims to explore further evidence regarding the clinical presentation, diagnosis, and timely management of these surgical complication, due to its rapid progression it can compromise the patient´s life.

Metrics

Metrics Loading ...

References

Lee MY, Dalpiaz A, Schwamb R. Clinical pathology of bartholin's glands: a review of the literature. Curr Urol. 2015;8:22. DOI: https://doi.org/10.1159/000365683

Omole F, Simmons BJ, Hacker Y. Management of Bartholin's duct cyst and gland abscess. Am Fam Physician. 2003;68:135.

Marzano DA, Haefner HK. The bartholin gland cyst: past, present, and future. J Low Genit Tract Dis. 2004;8:195. DOI: https://doi.org/10.1097/00128360-200407000-00006

Kessous R, Aricha-Tamir B, Sheizaf B, et al. Clinical and microbiological characteristics of Bartholin gland abscesses. Obstet Gynecol. 2013;122:794. DOI: https://doi.org/10.1097/AOG.0b013e3182a5f0de

Illingworth B, Stocking K, Showell M, et al. Evaluation of treatments for Bartholin's cyst or abscess: a systematic review. BJOG 2020;127:671. DOI: https://doi.org/10.1111/1471-0528.16079

Laucks SS. Fournier's gangrene. Surg Clin North Am. 1994;74:1339. DOI: https://doi.org/10.1016/S0039-6109(16)46485-6

Stevens DL, Bryant AE. Necrotizing Soft-Tissue Infections. N Engl J Med. 2017;377:2253. DOI: https://doi.org/10.1056/NEJMra1600673

Das DK, Baker MG, Venugopal K. Increasing incidence of necrotizing fasciitis in New Zealand: a nationwide study over the period 1990 to 2006. J Infect. 2011;63:429. DOI: https://doi.org/10.1016/j.jinf.2011.07.019

Eke N. Fournier's gangrene: a review of 1726 cases. Br J Surg. 2000;87:718.

Hua C, Urbina T, Bosc R, et al. Necrotising soft-tissue infections. Lancet Infect Dis. 2023;23:81. DOI: https://doi.org/10.1016/S1473-3099(22)00583-7

Stevens DL, Bisno AL, Chambers HF, Dellinger EP, Goldstein EJ, Gorbach SL, et al. Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the infectious diseases society of America. Clin Infect Dis. 2014;59(2):147-59. DOI: https://doi.org/10.1093/cid/ciu444

Eke N. Fournier's gangrene: a review of 1726 cases. Br J Surg. 2000;87(6):718-28. DOI: https://doi.org/10.1046/j.1365-2168.2000.01497.x

Kaul R, McGeer A, Low DE, Green K, Schwartz B. Population-based surveillance for group A streptococcal necrotizing fasciitis: Clinical features, prognostic indicators, and microbiologic analysis of seventy-seven cases. Ontario Group A Streptococcal Study. Am J Med. 1997 Jul;103(1):18-24. DOI: https://doi.org/10.1016/S0002-9343(97)00160-5

Hau V, Ho CO. Necrotising fasciitis caused by Vibrio vulnificus in the lower limb following exposure to seafood on the hand. Hong Kong Med J. 2011;17(4):335-7.

Hadeed GJ, Smith J, O'Keeffe T, Kulvatunyou N, Wynne JL, Joseph B, et al. Early surgical intervention and its impact on patients presenting with necrotizing soft tissue infections: A single academic center experience. J Emerg Trauma Shock. 2016;9(1):22-7. DOI: https://doi.org/10.4103/0974-2700.173868

Fernando SM, Tran A, Cheng W, Rochwerg B, Kyeremanteng K, Seely AJE, et al. Necrotizing soft tissue infection: diagnostic accuracy of physical examination, imaging, and LRINEC Score: A Systematic Review and Meta-Analysis. Ann Surg. 2019;269(1):58-65. DOI: https://doi.org/10.1097/SLA.0000000000002774

Bruls RJM, Kwee RM. CT in necrotizing soft tissue infection: diagnostic criteria and comparison with LRINEC score. Eur Radiol. 2021;31(11):8536-41. DOI: https://doi.org/10.1007/s00330-021-08005-6

Schmid MR, Kossmann T, Duewell S. Differentiation of necrotizing fasciitis and cellulitis using MR imaging. AJR Am J Roentgenol. 1998;170(3):615-20. DOI: https://doi.org/10.2214/ajr.170.3.9490940

Bjurlin MA, O'Grady T, Kim DY, Divakaruni N, Drago A, Blumetti J, Hollowell CM. Causative pathogens, antibiotic sensitivity, resistance patterns, and severity in a contemporary series of Fournier's gangrene. Urol. 2013;81(4):752-8. DOI: https://doi.org/10.1016/j.urology.2012.12.041

Provenzano D, Lo Bianco S, Zanghì M, Campione A, Vecchio R, Zanghì G. Fournier's gangrene as a rare complication in patient with uncontrolled type 2 diabetes treated with surgical debridement: A case report and literature review. Int J Surg Case Rep. 2021;79:462-5. DOI: https://doi.org/10.1016/j.ijscr.2021.01.098