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Fournier Gangrene

Fournier Gangrene is a topic covered in the 5-Minute Clinical Consult.

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  • Fournier gangrene is a life-threatening necrotizing skin infection of the genitals and/or perineum.
  • Urologic emergency requiring antibiotics and emergent surgical débridement

Fournier gangrene is a urologic emergency with a high rate of morbidity and mortality if not diagnosed and managed promptly.


  • 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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Stephens, Mark B., et al., editors. "Fournier Gangrene." 5-Minute Clinical Consult, 27th ed., Wolters Kluwer, 2019. Medicine Central, im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816897/2.1/Fournier_Gangrene.
Fournier Gangrene. In: Stephens MB, Golding J, Baldor RA, et al, eds. 5-Minute Clinical Consult. 27th ed. Wolters Kluwer; 2019. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816897/2.1/Fournier_Gangrene. Accessed June 18, 2019.
Fournier Gangrene. (2019). In Stephens, M. B., Golding, J., Baldor, R. A., & Domino, F. J. (Eds.), 5-Minute Clinical Consult. Available from https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816897/2.1/Fournier_Gangrene
Fournier Gangrene [Internet]. In: Stephens MB, Golding J, Baldor RA, Domino FJ, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2019. [cited 2019 June 18]. Available from: https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816897/2.1/Fournier_Gangrene.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Fournier Gangrene ID - 816897 ED - Stephens,Mark B, ED - Golding,Jeremy, ED - Baldor,Robert A, ED - Domino,Frank J, BT - 5-Minute Clinical Consult, Updating UR - https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/816897/2.1/Fournier_Gangrene PB - Wolters Kluwer ET - 27 DB - Medicine Central DP - Unbound Medicine ER -