AIM:The authors present a case of a patient with developed Fournièr gangrene and septic shock. Fournièr gangrene belongs to the group of local non-specific infection of soft tissues (NSTI). Its incidence is relatively low, but the infection is extraordinary aggressive with a possible lethal end.MATERIAL AND METHOD:39 years old patient with 4 days history of Fournier gangrene's development was admitted in irreversible septic shock. The initial APACHE II score was 36. The delay in treatment was an important factor in the further course of illness with lethal end.RESULTS:Above the mentioned 39 years old patient died because of septic shock. The hemorrhagic cystitis was the original source of infection with further development of Fournièr gangrene according to the pathological record.CONCLUSION:We often come across all different kinds of stages of sepsis from the MODS to the septic shock for patients with Fournièr gangrene. Causal treatment should be started early. The local surgical excision and wide broad antibiotic administrations are basic treatments in the context of other treatment modalities according to the current patient's needs. The adjuvant hyperbaric oxygen treatment takes place in patients with Fournièr gangrene as well and is beneficial. The following factor even worsens the illness prognosis: delay in diagnostic, higher age, anorectal origin of infection, the amount of organ with dysfunction or failure, diabetes mellitus and significant immunodeficiency.

INTRODUCTION:Bleeding in the upper part of GI tract is a serious condition requiring careful investigation and adequate treatment. The surgical treatment is irreplaceable in the case of unsuccessful conservative treatments. The timing of a surgical intervention in diagnostic-therapeutic algorithm is still controversial, although there are a lot of identification factors.MATERIAL:538 patients with bleeding I and IIA according to Forrest classification were hospitalized in surgical ICU in the period from July 2001 till December 2006. There were 310 men and 228 women together.RESULT:34 patients with mortality 17.6% were surgically treated after unsuccessful conservative and endoscopic treatment.CONCLUSION:The early surgical intervention for patients with bleeding from peptic ulcus decreases its mortality. The emergency surgical intervention is necessary for patients when bleeding continues in an adequate conservative treatment or in the excessive recurrent bleeding. It is also necessary when the active bleeding is not endoscopicaly treatable or approachable. The number of emergency surgical interventions can be decreased by effective endoscopical treatment and by stabilization of patients. In the case of the location of bleeding in the back wall of duodenal bulbus or in the location of little curvature and especially in bigger peptical lesions the elective surgical intervention should be concerned because of the high risk of recurrence of bleeding. The mortality rate in emergency surgical intervention for excessive bleeding ranges from 10 till 50% compared with elective operations according to literature.

Carnobacterium piscicola was first described in 1984. These bacteria are often isolated from fish afflicted with bacterial infections. To date, there has been no reported isolation of this bacterium from human specimens. We report here the isolation of C. piscicola from the pus following traumatic amputation of the right hand in the wrist of a 35-year-old man. The traumatic amputation occurred with an industrial water sawmill. The identity of the human strain was determined biochemically, by 16S rDNA sequence similarity and by fatty-acid methyl-ester profile from bacterial cell.

The authors present the results of treatment provided to 11 patients with necrotizing fasciitis who were after a surgical operation and after administration of antibiotics treated in a hyperbaric chamber. A total of 8 patients (82%) recovered completely. The authors discuss the theory of action of hyperbaric oxygen on microorganisms and draw attention to the possible reduction of mortality of this serious disease when using hyperbaric oxygenation. The latter is considered an important auxiliary method which supplements surgical treatment, rational antibiotic therapy and in particular careful intensive care.