Fournier gangrene

Perineal necrotising soft tissue infection, commonly called Fournier gangrene, is a necrotising soft tissue infection occuring in the perineum, scrotum, and penis. It's a polymicrobial infection with bacteria entering the region through abscess, fissure, fistula, colon perforation, etc. It's more common in immunocompromised people. It's a rare cause of acute scrotum.

Fournier gangrene is a urological emergency as it has a high (20%) mortality and requires urgent treatment to improve prognosis.

Clinical features

• Pain
• Foul smell
• Skin necrosis
• Fever
• Sepsis

Management

• Wide spectrum antibiotic therapy
  • Against both aerobes and anaerobes
• Suprapubic catheter (to relieve the infected area)
• Surgical excision and debridement
• Hyperbaric oxygen therapy