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