Fournier’s gangrene is an acute, rapidly progressive, necrotizing infection of the skin and subcutaneous tissues surrounding the genitals and perineum. Necrotizing fasciitis of the genital area is a rare disease entity. Although it concerns mostly males, can also occur in females and adolescents. In this syndrome, bacteria produce gases which accumulate in the infected tissue. The damage may also comprise tissue of the penis and scrotum. The infection is caused by aerobic and anaerobic bacteria. Usually the Fournier’s gangrene is caused by Staphylococci, Streptococci and Enteric bacteria. Bacterial infection can accompany the fungal infection. The high mortality rate is associated with bacterial contagion of the skin, fat, fascia and blood vessels. Harmful enzymes, produced by micro-organisms, induce numerous blood clots. They can lead to ischemia, which contribute to the development of necrosis. Fournier’s syndrome is a disease with a high mortality rate. Immunodeficiency, diabetes and chronic alcohol abuse favor the development of gangrene. Abrasion, burn or surgery complication may be the route of infection for microorganisms. Clinical symptoms appear within few days. Diagnostic process is based on the clinical picture. It is crucial to start treatment as soon as possible. Delay of the wide spectral intravenous antibiotic therapy and surgical removal of the necrotic tissue may result in death of the patient.

Fournier’s gangrene, necrotizing fasciitis, syndrome

JA Fournier. Gangrene Foudroyant de la verge. Medecin Pratique. 1883; 4: 589-97.

A Kilic, Aksoy Y's Kilic L. Fournier gangrene: etiology, treatment, and complications. Ann Plast Surg. 2001; 47: 523-527.

Quatan N, Kirby RS. Improving outcomes in Fournier's gangrene. BJU Int. 2004; 93: 691-692.

Adams JA, Culkin DJ, I Mata, Bocchini I, Venable DD. Fournier's gangrene in children. Urology. 1990; 35: 439-41.

JF Redman, Yamauchi T, Higginbothom EC. Fournier's gangrene of the scrotum in a child. J Urol. 1979; 121: 827.

CF Heyns, Fisher M. The urological management of the patient with acquired immunodeficiency syndrome. BJU Int. 2005; 95: 709-716.

Inadełek J. Diagnostic investigation and management of Fournier's gangrene in intensive care unit. New Medicine. 2016 3: 102-113.

Baskin LS, Carroll PR, EV Cattolica, McAninch JW. Necrotising soft tissue infections of the genitals and perineum. Br J Urol. 1990; 65: 524-529.

Laor E Palmer LS, Tolia BM Reid RE Winter HI. Outcome prediction in patients with Fournier's gangrene. J Urol. 1995; 154: 89-92.

Yeniyol CO, T Suelozgen, Arslan F, Ayder AR. Fournier's gangrene: Experience with 25 patients and use of Fournier's gangrene severity index score. Urology. 2004; 64: 218-22.

A Tuncel, Aydin O Tekdogan U, V Nalcacioglu, Capar Y Atan A. Fournier's gangrene: Three years of experience with 20 patients and validity of the Fournier's gangrene severity index score. Eur Urol. 2006; 50: 838-43.

Jeong HJ, Park SC, Seo IY, Rim JS. Prognostic factors in Fournier gangrene. Int J Urol. , 2005; 12: 1041-1044.

Sorensen MD, Krieger JN, Rivara FP, et al. Fournier's gangrene: population based epidemiology and outcomes. J Urol. 2009; 181: 2121-2126.

GL Smith, Bunker CB Dinneen MD. Fournier's gangrene. Br J Urol. 1998; 81: 347-355.

Paty R, Smith AD. And gangrene Fournier's gangrene. Urol. Clin. N. America. 1992; 19: 149-162.

Ledingham IM, Tehrani MA. Diagnosis, clinical course and treatment of acute dermal gangrene. Br J Surg. 1975; 62: 364-72.

Chantarasak ND, PK Basu. Fournier's gangrene Following a vasectomy. Br J Urol. 1989; 61: 538-9.

JR Pryor, Bella JY, Packham DA. Scrotal gangrene after male sterilization. Br Med J. 1971; 51: 272.

McLaughlin S, Gray J. Delayed recognition of an abscess intersphincteric as the underlying cause of scrotal's Fournier gangrene. Ann R Coll Surg Engl. 1985; 67: 137-8.

Huber P, Kissak A Simonton C. Necrotizing soft tissue infection from rectal abscess. Dis Colon Rectum. 1983; 26: 507.

Bevans D Westbrook K, B Thompson et al. Perirectal abscess: a Potentially fatal illness. Am J Surg. 1973; 126: 765-8.

Clay L, White J, J Davidson et al. Early recognition and successful management of pelvic cellulitis Following haemorrhoidal banding. Dis Colon Rectum. 1986; 29: 579-81.

Cunningham B, Nivatvongs S, Fournier A. Shons's syndrome Following Mucosal anorectal examination and biopsy. Dis Colon Rectum. 1979; 22: 51-4.

Flanigan R, Kursch E, in McDougal et al. Synergistic gangrene of the scrotum and penis is secondary colorectal disease. J Urol. 1978; 119: 369-71.

Dewire D J. Bergstein carcinoma of the sigmoid colon: an unusual cause of Fournier's gangrene. J Urol. 1992; 147: 711-2.

Kuzak B, Jardanowski R Dobroński P. gangrene Fourier-case. Pol Urol. 1998; 51: 93-100.

Corman JM, Moody JA, Aronson WJ. Fournier's gangrene in a modern surgical setting: improved survival with aggressive management. Br J Urol. 1999; 84: 85-88.