Fact-sheet: Fournier gangrene
Updated on 10/03/2018 at 8:59 AM
View all RADEOS cases associated with this fact-sheet
Definition
Rapidly progressive Necrotizing fasciitis of the Perineum and external genitalia.
Polymicrobial infection.
Rare, severe, high mortality.
Secondary to a loco-regional cause in 95% of cases: cutaneous, urogenital, or colorectal.
Predisposing factor: diabetes present in 60% of cases.
Clinical features
Insidious onset (sometimes simple pruritus or pain in the external genitalia).
Pain then becomes predominant, with the onset of fever and systemic signs.
Local signs: crepitus ++
Systemic signs disproportionately severe compared to local signs
CT
Should not delay treatment
Determines the cause, extent, and guides the type of debridement
Visualization of gas
Asymmetric fascial thickening, collection, abscess, fat stranding
Search for an underlying cause
Management
Emergency
Debridement after hemodynamic stabilization (fluid and electrolyte resuscitation): surgical treatment with hyperbaric oxygen therapy
Antibiotic therapy
Skin graft
Differential diagnosis
Cellulitis