We present the pathogenic and the therapeutic features of the extensive necrotizing perineal infections in diabetic patients, based on the clinical experience of our surgical department (45 cases in 10 years) and on the data in the medical literature. We analyzed the case of a 45 years male with an unbalanced type I diabetes mellitus, which has been admitted for an extensive necrotizing infection of the lower abdominal wall (hypogastrium and both right and left lower quadrant), with crepitation on this area. The origin of this necrotizing infection was an upward extension of an insufficiently drained right ischiorectal abscess. The therapeutic management consisted in 6 consecutive surgical procedures (drainage, necrectomy, large fasciectomy), which permitted a favourable evolution and the healing of the patient. We used this demonstrative case for emphasizing the clinical, paraclinical and therapeutical peculiarities of the extensive perineal infections in diabetic patients.
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