Fournier's gangrene

Question 1

What is Fournier’s gangrene?

Answer 1

A form of necrotising fasciitis occurring about the male genitalia

Question 2

Where does Fournier’s gangrene most commonly arise?

Answer 2

Skin around urethra or rectal region

Question 3

What are some predisposing factors for Fournier’s gangrene?

Answer 3

• Diabetes
• Local trauma
• Periurethral extravasion
• Perianal infection

Question 4

Describe the microbiology of Fournier’s gangrene

Answer 4

Usually a mixture of aerobes/anaerobes

Question 5

Presentation of Fournier’s gangrene

Answer 5

• Starts as cellulitis
  
  • Swollen, erythematous, tender
  • Marked pain, fever, systemic toxicity
• Swelling and crepitus of scrotum, dark purple areas
• Often marked toxicity out of proportion to the local findings

Question 6

What investigations are required in Fournier’s gangrene?

Answer 6

Plain x-ray/USS may confirm gas in tissues if doubt (not usually needed)

Question 7

How is Fournier’s gangrene

Answer 7

• Antibiotics and surgical debridement
• Mortality is 20%