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자료유형
학술저널
저자정보
노병관 (Department of Surgery Pusan National University Hospital) 이누리 (Department of Surgery Veterans Health Service Medical Center) 이병철 (Department of Surgery Pusan National University Hospital) 윤명희 (부산대학교)
저널정보
대한이식학회 Clinical Transplantation and Research Korean Journal of Transplantation Vol.35 No.3
발행연도
2021.9
수록면
195 - 199 (5page)
DOI
10.4285/kjt.21.0013

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Bacterial infection represents a turning point in the natural history of cirrhosis, causing the development of acute-on-chronic liver failure. It significantly affects the outcome of patients listed for liver transplantation. We report the case of a 57-year-old man who had been regularly treated for hepatitis B virus, alcoholic liver cirrhosis, and hepatic failure. The patient was hospitalized again due to variceal bleeding and hepatic coma. He vis- ited the emergency room with painful anal swelling, dysuria, icteric sclera, and serious abdominal distension. The painful anal swelling and necrosis progressed; thus, he was diagnosed with Fournier’s gangrene. Enterococcus faecium and Candida albicans were detected in the blood. Gangrene wound debris was studied extensively. Despite appropri- ate antibiotic treatment, vancomycin-resistant enterococcus and C. albicans were con- tinuously present in the blood. Wide debridement of the wound and T-colostomy were performed. After this, norepinephrine and vasopressin were used to maintain stable vital signs. It was difficult to establish a liver transplant operation. Despite repeated bleeding, bacterial infections improved with additional antibiotics. Finally, selected deceased do- nor liver transplantation in controlled Fournier’s gangrene was successfully performed. Controlled infections may be allowed in transplantation surgery.

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