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Fournier's Gangrene — Emergency

Rapidly progressive necrotising fasciitis of the perineal, genital and perianal region.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Acil Servis department. Book Appointment →

What is Fournier's Gangrene — Emergency?

Fournier's gangrene is a polymicrobial necrotising fasciitis caused by aerobic and anaerobic bacteria of the perineal-genital region.

Sources include perianal abscess, urethral injury, scrotal infection, ischiorectal abscess and immunosuppressive conditions.

Surgical debridement, broad-spectrum antibiotics and intensive care are mandatory; without surgery in the first hours, mortality is very high.

Symptoms

Severe pain and oedema in the perineal-scrotal area
Skin redness, ecchymosis and bullous lesions
Crepitus (subcutaneous gas) on palpation
Foul-smelling discharge and necrotic skin
Fever, chills and signs of sepsis
Tachycardia, hypotension and confusion
Rapid spread to abdominal wall and thighs

Risk Factors

Diabetes mellitus (50-70% of cases)
Obesity, alcoholism and malnutrition
Immunosuppression (HIV, chronic steroid use)
Chronic kidney disease and dialysis
Recent perianal surgery or urethral instrumentation
Liver cirrhosis and chemotherapy
Old age (>60 years) and male sex

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Emergency presentation by 112 ambulance is mandatory for severe perineal-scrotal pain, swelling and crepitus
  • Surgical consultation, broad-spectrum antibiotic and aggressive debridement are needed within minutes
  • Hyperbaric oxygen therapy may be added in selected centres
  • After multiple debridements, reconstruction and stoma may be needed

Treatment Methods

01
Emergency wide surgical debridement of all necrotic tissue
02
Broad-spectrum antibiotic (piperacillin-tazobactam + clindamycin + carbapenem)
03
Aggressive intravenous fluid resuscitation and intensive care
04
Diverting colostomy (perianal involvement)
05
Glycaemic control and treatment of underlying causes
06
Hyperbaric oxygen therapy (selected cases) and reconstructive surgery

Which Department to Visit?

You can visit our Acil Servis department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.