The Immunological Differences Between Fournier Gangrene and Perianal Abscess
Condition: Fournier Gangrene; Perianal Abscess
MeSH terms: Abscess; Fournier Gangrene; Gangrene
Study type: Observational

Summary: 
      Although it is rarely observed, necrotizing fasciitis progresses with high mortality and
      serious complications. Fournier's gangrene is a specific form of necrotizing fasciitis. In
      laboratory tests, leukocytosis or leukopenia, anemia, lymphopenia can be observed. Perianal
      abscess is a surgical emergency that is observed much more frequently than necrotizing
      fasciitis. Although Fournier's gangrene has many different etiologies, it rarely occurs due
      to the progression of perianal abscess, and although it is difficult to distinguish between
      these two diseases at diagnosis, the two diseases manifest themselves as different entities.
      In this study, blood cytokine levels will be evaluated in patients with Fournier's gangrene
      and perianal abscess, and the role of blood cytokine levels in the differential diagnosis of
      these two diseases will be investigated.
    

Detailed description: 
      Although it is rarely observed, necrotizing fasciitis progresses with high mortality and
      serious complications. Fournier's gangrene is a specific form of necrotizing fasciitis and is
      located in the external genital organs and perianal region, causing thrombosis in the
      arteries feeding this region, gangrene in the skin and subcutaneous tissues, sepsis, and
      multiorgan failure.

      The prognosis of Fournier's gangrene is closely related to the time of initiation of
      treatment. In cases where treatment is delayed, high mortality can be observed due to septic
      shock and related complications.

      In laboratory tests, leukocytosis or leukopenia, anemia, and lymphopenia can be observed. In
      a study evaluating conditions that increase mortality with soft tissue necrosis, it was
      reported that high body mass index, abnormal leukocytes, CRP and platelet values were
      proportional to the severity of the disease.

      Perianal abscess is a surgical emergency that is observed much more frequently than
      necrotizing fasciitis. Patients usually present with an erythematous swelling near the anus
      and hesitate to be examined. About 90% of idiopathic perianal abscesses occur due to
      infection of the cryptoglandular glands.

      Although Fournier's gangrene has many different etiologies, it rarely occurs due to the
      progression of perianal abscess, and although it is difficult to distinguish between these
      two diseases in the diagnosis, the two diseases manifest themselves as different entities. In
      a study, higher IL17 levels were found in perianal abscess patients compared to the control
      group. Apart from this, we did not find any study on blood cytokine levels in patients with
      perianal abscess or Fournier's gangrene in our literature review.

      In this study, blood cytokine levels will be evaluated in patients with Fournier's gangrene
      and perianal abscess, and the role of blood cytokine levels in the differential diagnosis of
      these two diseases will be investigated.
    

Intervention name(s): Cytokine levels
Intervention type(s): Diagnostic Test
Intervention description(s): Preoperative cytokine levels of the patients
Observational model: Cohort
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        In this study, patients who applied to the emergency department with rectal pain and were
        diagnosed with perianal abscess or Fournier's gangrene and volunteers in the same age range
        without any disease will be included.
      
Keywords: Cytokine; inflammation; Fournier Gangrene; Perianal Abscess