Fournier gangrene

Fournier Gangrene is a rare and often severe form of necrotizing fasciitis or gangrene specifically affecting the external genitalia or perineum. It was first described by Baurienne in 1764 and later named after French venereologist Jean Alfred Fournier in 1883.

Introduction

Fournier Gangrene predominantly affects older men, but it can also occur in women and children. This condition is more commonly found in individuals with diabetes, alcoholism, or those who are immunocompromised. The condition is rare, with an incidence of about one per 62,500 males per year, and males are affected approximately 40 times more often than females.

Clinical Presentation

The initial symptoms of Fournier Gangrene include sudden pain in the scrotum, fever, pallor, and generalized weakness. The pain often extends beyond the area of visible redness on the skin (erythema). It typically begins as a subcutaneous infection, but necrotic patches soon appear on the overlying skin, which subsequently develop into full-blown necrosis.

Most cases of Fournier Gangrene present mildly but can progress rapidly within hours. More advanced cases are characterized by a foul odor and necrotic infected tissue. Subcutaneous air, detectable as crepitus (a crackling sensation under the skin), is often one of the specific clinical signs, but it is not seen in more than 50% of presenting clinical cases.

Treatment and Prognosis

The management of Fournier Gangrene involves prompt surgical debridement, broad-spectrum antibiotics, and supportive care. Despite aggressive treatment, the condition carries a high mortality rate, underscoring the importance of early recognition and management.

See Also

• Necrotizing fasciitis
• Gangrene
• Diabetes mellitus

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