Fournier Gangrene
Basics
Description
- Fournier gangrene is a life-threatening necrotizing skin infection of the genitals and/or perineum.
- Urologic emergency requiring antibiotics and emergent surgical débridement
ALERT
Fournier gangrene is a urologic emergency with a high rate of morbidity and mortality if not diagnosed and managed promptly.
Fournier gangrene is a urologic emergency with a high rate of morbidity and mortality if not diagnosed and managed promptly.
Epidemiology
Incidence
- The majority of patients are between 50 and 79 years of age, but it can occur at all ages.
- Male > female 10:1
- White (52.3%)
- Most patients have >2 comorbidities.
- Incidence 1.6 in 100,000
- 0.02% of hospitalized patients
Etiology and Pathophysiology
- Etiology
- Often polymicrobial (83%)
- Common organisms include
- Bacteroides (43.9%)
- Escherichia coli (36.6%)
- Prevotella (34.1%)
- Other organisms isolated include Staphylococcus, Streptococcus, Candida.
- Pathophysiology
- Infection, typically polymicrobial, occurs in the genitals or perineum.
- Develops into a synergistic necrotizing fasciitis
- Leads to thrombosis of adjacent subcutaneous vessels resulting in gangrene
- Left untreated, it progresses to sepsis and death.
Risk Factors
- Alcohol abuse
- Diabetes
- Extremes of age <10 years old or >50 years old
- IV drug abuse
- Recent genital or perineal trauma or infection
- Recent penile, perineal, or perirectal surgery
- Immunocompromised state
- Chronic renal failure
- Chronic liver disease
- Peripheral vascular disease
General Prevention
- Routine hygiene
- Modification of risk factors
Commonly Associated Conditions
- Perirectal abscess
- Urethral strictures
- Testicular infections (epididymitis, orchitis)
- Skin infections (hidradenitis, folliculitis, cellulitis)
- Sepsis
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Citation
Domino, Frank J., et al., editors. "Fournier Gangrene." 5-Minute Clinical Consult, 33rd ed., Wolters Kluwer, 2025. Medicine Central, im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/1688603/all/Fournier_Gangrene.
Fournier Gangrene. In: Domino FJF, Baldor RAR, Golding JJ, et al, eds. 5-Minute Clinical Consult. Wolters Kluwer; 2025. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/1688603/all/Fournier_Gangrene. Accessed October 10, 2024.
Fournier Gangrene. (2025). In Domino, F. J., Baldor, R. A., Golding, J., & Stephens, M. B. (Eds.), 5-Minute Clinical Consult (33rd ed.). Wolters Kluwer. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/1688603/all/Fournier_Gangrene
Fournier Gangrene [Internet]. In: Domino FJF, Baldor RAR, Golding JJ, Stephens MBM, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2025. [cited 2024 October 10]. Available from: https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/1688603/all/Fournier_Gangrene.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC
T1 - Fournier Gangrene
ID - 1688603
ED - Domino,Frank J,
ED - Baldor,Robert A,
ED - Golding,Jeremy,
ED - Stephens,Mark B,
BT - 5-Minute Clinical Consult, Updating
UR - https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/1688603/all/Fournier_Gangrene
PB - Wolters Kluwer
ET - 33
DB - Medicine Central
DP - Unbound Medicine
ER -