FOURNIER’S GANGRENE

• Also called as idiopathic gangrene of the scrotum.
• It is a vascular gangrene, a form of necrotizing fasciitis, with abrupt onset of a rapidly fulminating genital gangrene of idiopathic origin and gangrene upto deep fascia.
• Trauma, infection –> microorganism –> inflammation –> obliterative arteritis –> scrotal gangrene
• Common in diabetics (MC)

 

ETIOLOGY-

• Haemolytic streptococci, staphylococci, E.coli,Bacteriodes (anaerobes)
• Malnourished, immunosuppression

 

CLINICAL FEATURES-

• Sudden pain and inflammation in scrotum along with fever, toxicity
• Extensive gangrene of the scrotal skin results in sloughing of the scrotal skin exposing testicles (skin, superficial and deep fascia are destroyed)
• Perineal phlegmon– gangrene involving skin of penis, anterior abdominal wall, medial side of thigh, perianal region.
• Testis not involved due to thick tunica albuginea.
• Crepitus is present

 

TREATMENT-

• IV hydration, antibiotics, surgical debridement of the necrotic fat and fascia.
• Mortality without treatment (7- 75%)
• Surgical debridement is the needed with serial debridement is required too.

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