Fournier

Fournier's gangrene is a type of necrotizing fasciitis or gangrene affecting the external genitalia or perineum. It commonly occurs in older men, but it can also occur in women and children. It is characterized by sudden pain, tenderness, and swelling in the genital area. The condition is considered a medical emergency due to its rapid progression.

Causes

Fournier's gangrene is caused by a polymicrobial infection, with both aerobic and anaerobic bacteria present. The most common bacteria involved are Escherichia coli, Bacteroides, Streptococcus, and Staphylococcus. The infection often begins in the perineal area due to a local trauma, surgery, or infection. It can also be associated with systemic diseases such as diabetes, alcoholism, and immunosuppression.

Symptoms

The symptoms of Fournier's gangrene include sudden pain and swelling in the genital area, fever, fatigue, and malaise. The skin may become discolored, with a purplish or blackish hue, and there may be a foul-smelling discharge. As the disease progresses, the patient may develop septic shock, which can be life-threatening.

Diagnosis

The diagnosis of Fournier's gangrene is primarily clinical, based on the patient's symptoms and physical examination. Imaging studies such as computed tomography (CT) or magnetic resonance imaging (MRI) can be used to confirm the diagnosis and assess the extent of the disease. Laboratory tests may show an elevated white blood cell count and other signs of infection.

Treatment

The treatment of Fournier's gangrene involves aggressive surgical debridement of the necrotic tissue, broad-spectrum antibiotic therapy, and supportive care. Hyperbaric oxygen therapy may also be used. Despite aggressive treatment, the mortality rate remains high, ranging from 20% to 50%.

See also

• Necrotizing fasciitis
• Gangrene
• Perineum
• Septic shock

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