VA Resident Report: Review of Fournier’s gangrene

The Bottom Line: Fournier’s gangrene is a progressive necrotizing soft-tissue infection (NSTI) of the external genitalia and/or perineum. It is a urological emergency requiring prompt diagnosis and treatment — even with administration of parenteral broad-spectrum antibiotics and expedited aggressive surgical debridement, the disease can be fatal.

References: Hagedorn, J., & Wessells, H. (n.d.). A contemporary update on Fournier’s gangrene. Nature Reviews., 14(4), 205-214.

Summary: A high level of suspicion with prompt resuscitation and surgical intervention are the key for optimizing patient outcomes. For equivocal cases, several diagnostic tools, including laboratory tests and imaging, have been developed to be used in conjunction with physical examination findings. Most infections are polymicrobial, requiring broad-spectrum antibiotics and wide surgical debridement. Wound preparation with dressing changes and further debridements are essential for successful reconstruction once the local necrotic process and systemic infection has been treated.
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