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Potentially life-threatening emergency
Fournier gangrene - Anogenital in
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Potentially life-threatening emergency

Fournier gangrene - Anogenital in

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Contributors: Lowell A. Goldsmith MD, MPH, Benjamin K. Fisher MD
Other Resources UpToDate PubMed

Synopsis

Fournier gangrene is the name given to necrotizing fasciitis involving the genital, perianal, or perineal regions. Gangrene results when the infection leads to thrombosis of the regional subcutaneous blood vessels. It is usually polymicrobial and results from trauma to the anogenital region (eg, surgical procedure) or spread of infection from nearby perineal structures (perianal glands, urinary tract infection, etc). Individuals with diabetes mellitus, chronic alcohol use disorder, or who are otherwise immunosuppressed are at increased risk for Fournier gangrene. Men are affected much more frequently than women.

Fournier gangrene presents with pain, swelling, and erythema in the genital region and rapidly evolves to bullae formation and skin necrosis. There is often associated fever and lethargy. The mortality rate varies from 345%, and causes of death have included sepsis, coagulopathy, renal failure, diabetic ketoacidosis, and multiple organ failure.

Refer to Diagnostic Pearls for tips on distinguishing Fournier gangrene from cellulitis. Therapy requires immediate surgical intervention in addition to antibiotics. Therefore, if you are considering this diagnosis, contact a surgeon NOW.

Codes

ICD10CM:
N49.3 – Fournier gangrene

SNOMEDCT:
398318005 – Fournier gangrene

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

Best Tests

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Management Pearls

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Therapy

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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References

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Last Updated: 06/08/2018
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Potentially life-threatening emergency
Fournier gangrene - Anogenital in
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View all Images (4)
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Fournier gangrene : Edema, Erythema, Gangrene, Genitals, buttocks, perineum, Painful skin lesions
Clinical image of Fournier gangrene
Copyright © 2018 VisualDx®. All rights reserved.