Elsevier

Urology

Volume 114, April 2018, Pages 8-13
Urology

Review Article
Presentation and Diagnosis of Fournier Gangrene

https://doi.org/10.1016/j.urology.2017.10.031Get rights and content

Necrotizing fasciitis is a severe type of necrotizing soft tissue infection involving the superficial fascia and subcutaneous tissues. Fournier gangrene, a type of necrotizing fasciitis, affects the genitalia or perineum. Although a rare health condition, Fournier gangrene can result in significant morbidity and unnecessary mortality following delay in diagnosis and management. We provide a review of relevant presenting features to aid diagnosis and allow timely surgical management of this serious infectious condition.

Section snippets

Anatomy

Understanding the fascial anatomy allows a better understanding of how NSTIs that originate in the urogenital or anogenital region (ie, Fournier gangrene) can spread to the abdomen, chest, and flank. Fournier gangrene spreads across the superficial and deep fascial planes of the urogenital and anogenital region. Infection of the deep tissues results in vascular occlusion, ischemia, and tissue necrosis. The hypoxia will consequently cause infarction of the nerves that initially is painful and

Diagnosis

Necrotizing soft tissue is the most important component of Fournier gangrene. These infections are characterized a high morbidity or mortality; therefore, a high index of suspicion is paramount. Often clinical findings and the patient's medical condition can facilitate accurate diagnosis; however, laboratory tests and radiographic technology can augment the early diagnosis of Fournier gangrene.

Summary

Fournier gangrene is a life-threatening diagnosis that requires early diagnosis to reduce morbidity and mortality. Knowledge of anatomy, risk factors, and etiology can be helpful when these rare cases are suspected. Although clinical diagnosis is the most common method to diagnose Fournier gangrene followed by expeditious surgical debridement, laboratory and radiography services can serve as useful adjuncts.

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  • Cited by (0)

    Financial Disclosure: The authors declare that they have no relevant financial interests.

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