Singap Med J
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Review Case Reports
Use of adjunctive treatments in improving patient outcome in Fournier's gangrene.
Fournier's gangrene is a polymicrobial necrotising soft tissue infection (NSTI) affecting the perineum and scrotum. It is rapidly progressive and destructive, and is associated with high morbidity and mortality. ⋯ We report Fournier's gangrene in a 60-year-old diabetic man and his successful treatment with skin grafting, which utilised a multidisciplinary approach and adjuncts, including negative-pressure wound therapy and hyperbaric oxygen therapy. We also review the literature related to these adjuncts and discuss their usefulness in the management of NSTIs.
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Cor triatriatum is a congenital heart malformation that is characterised by the division of the left or right atrium into two separate chambers by a membrane or diaphragm. Reports among adults are scarce, as most cases are diagnosed during childhood. The risk of mortality is increased when cor triatriatum is complicated by pulmonary hypertension. ⋯ Echocardiography showed a membrane dividing the left atrium into two. Doppler studies revealed a reversal of normal flow, similar to mitral stenosis. The right ventricle was dilated, with reduced long axis function.