Fournier's Gangrene

ABSTRACT

Fournier's gangrene is a rare malignant surgical infection of the perineum, scrotum, and low abdominal areas. It usually occurs after anorectal infections, genitourinary infections, and traumatic injuries. We experienced 12 cases of Fournier's gangrene from 1988 to 1996; the mean age was 60.25 years with an age range of 30 to 83, and the male to female ratio was 11 :1. The most common disease associated with Fournier's gangrene was Diabetes mellitus, 3 cases (27.2%), and the most common cause of the gangrene was perianal abscess, 6 cases (54.5%). We do aggressive surgical debridement combined with a broad spectrum antibiotics therapy on all patients. There were two colostomy cases:one involved severe perianal tissue necrosis; the other was a in rectal cancer perforation. The most commonly cultured organism was E. coli, 5 cases (41.6%). There was one mortality; that patient was died from Adult respiratory distress syndrome and sepsis on the 13th admission days. The average number of admission days were 54.25 days. The mortality from Fournier's gangrene is still high; thus, an important factor in treatment is the suspicion of this disease entity, and examination under anesthesia with aggressive surgical debridement with massive systemic antibiotic therapies is essential.