Infectious Disease Compendium

Fournier's Gangrene

Diagnosis

A mixed synergistic necrotizing fasciitis in the perineum of diabetics.

Epidemiologic Risks

Diabetes, elderly, immunoincompetent, often there is no preceding trauma. Can occur in normal hosts, as in (Fournier's Gangrene due to Masturbation in an Otherwise Healthy Male). And you though blindness and hairy palms were bad.

Often starts as a perianal abscess.

Microbiology

Mixed/colonic flora: streptococci plus anaerobes plus coliforms.

Empiric Therapy

Surgery is the primary treatment, for antibiotics (third generation cephalosporins PLUS metronidazole) OR carbapenems alone OR (quinolone PLUS metronidazole) OR penicillin/beta-lactamase inhibitors.

Pearls

Nothing heals like cold steel; it is a surgical disease first.

First described by Jean-Alfred Fournier in 1883 Gangrène foudroyante de la verge (overwhelming gangrene). I remember walking by the Place du Docteur-Alfred-Fournier when in Paris (PubMed).

According to the Wikipedia, "The most historically prominent sufferers from this condition may have been Herod the Great, his grandson Herod Agrippa, and possibly the Roman emperor Galerius."

What infects humans, crocodiles and dolphins?

Last Update: 07/22/18.