A horrendous infection of the genitalia that causes
severe pain in the genital area (in the penis and scrotum or perineum) and progresses
from erythema (redness) to necrosis (death) of tissue. Gangrene can occur within
hours. The mortality (death) rates are up to 50%.
In this major medical emergency, a bacterial infection spreads quickly from the
urinary tract (or the perianal, abdominal, or retroperitoneal areas), often following
trauma. The gangrene is due to thrombosis of small blood vessels below the skin.
Fornier's gangrene has been thought to strike mainly men over 50. Today the disease
is not limited to older males or to men (although women are less commonly affected
than men). Fourier's gangrene can also occur in children from infancy to adolescence
following such events as insect bites, trauma, burns, perirectal diseases and infections.
Predisposing factors in all age ranges include diabetes, immunodeficiency and corticosteroid
use.
Treatment is urgent. It involves surgically cutting away (debriding) the infected
and necrotic (dead) tissue. Depending on the extent of the infection, surgical exploration
of the abdomen and a colostomy also may be necessary. Triple-drug antibiotic therapy
is given with, for example, Flagyl (metronidazole), ampicillin, and gentamicin.
The syndrome is named for Jean Alfred Fournier, a French venereologist (venereal
disease specialist), who first described it in 1883.
Common Misspellings: fournier's gangrine, fournier's gangreen
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