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Introduction

Fournier gangrene is a life-threatening, rapidly-spreading form of necrotizing fasciitis that involves the perineal, perianal, and genital areas.  It is typically a polymicrobial infection that spreads quickly along fascial planes and causes ischemia and necrosis of the soft tissues; it can quickly lead to sepsis and death without intervention.  Presenting symptoms include severe perineal/genital pain out of proportion to examination.  Fever, crepitus, bullae, and hypotension develop as the infection progresses.  Treatment includes immediate surgical intervention for debridement of gangrenous tissue and broad-spectrum antibiotics.

Risk factors

Risk factors for Fournier gangrene include:

  • Diabetes mellitus
  • Peripheral vascular disease
  • Obesity
  • Immunosuppression
  • Male sex (10:1 male-to-female ratio)
  • Age >50
  • Alcohol dependence
  • Genitourinary tract infection (eg, perirectal abscess)
  • Perineal trauma or surgery (eg, prostate biopsy)

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