Fournier Gangrene

Excerpt

Fournier gangrene, a relatively rare form of necrotizing fasciitis, is a rapidly progressive disease that affects the deep and superficial tissues of the perineal, anal, scrotal, and genital regions. Named after Dr. Alfred Fournier, the French dermatology and venereal specialist, it was initially described in 1883 as necrotizing fasciitis of the external genitalia, perineal, and perianal region in five of Dr. Fournier’s patients. Also known as necrotizing fasciitis, the disease involves the rapid spread of severe inflammatory and infectious processes along fascial planes affecting adjacent soft tissue; therefore, the disease may initially go unnoticed or unrecognized as there may be minimal or no skin manifestations in its early stages.

Fournier gangrene is often associated with general signs of sepsis, rapid tissue destruction, and a high fatality rate of 40%. The spread of inflammation and infection leads to thrombosis of blood vessels, which in turn causes ischemia and tissue necrosis of the adjacent soft tissue and fascia. The infectious and inflammatory process spreads quickly along the Dartos, Colles, and Scarpa’s fascias, allowing for the early involvement of the abdominal wall. Due to initial fascial and subcutaneous involvement, clinicians can miss this disease in its early stages because the overlying soft tissue can often look unremarkable or appear as simple cellulitis. Early diagnosis and treatment of this potentially fatal disease are key as it can easily get misdiagnosed initially as an otherwise benign process.