Fournier gangrene

From greek.doctor

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