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Fournier's Gangrene of the ScrotumA Poorly Defined Syndrome or a Misnomer?
Robert C. Lamb, MD;
George L. Juler, MD
Arch Surg. 1983;118(1):38-40.
Abstract
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• Fournier's gangrene is defined classically as a fulminant, rapidly spreading infection of the scrotum that also involves the perineum, penis, and abdominal wall. The pathologic findings are described as synergistic gangrene secondary to a polymicrobial flora with a poorly defined portal of entry. In our experience with 12 cases, the portal of entry was well defined and the causative organisms were those typically found in the lower bowel. Portals of entry were perirectal abscesses in five patients, urethral infections in three, and surgical procedures in four patients. All patients required aggressive surgical debridement, broad-spectrum antibiotics, and adjunctive measures. The fact that four patients died in spite of aggressive treatment demonstrates the lethal nature of this disease. This study suggests that this syndrome is no longer "idiopathic" but is primarily a necrotizing cellulitis of the perineum with subsequent involvement of the genitalia and surrounding tissues.
(Arch Surg 1983;118:38-40)
Author Affiliations
From the Departments of Surgery, Veterans Administration Medical Center, Long Beach, Calif, and the University of California, Irvine, College of Medicine, Orange.
Footnotes
Accepted for publication June 8, 1982.
Read before the annual meeting of the Southern California Chapter of the American College of Surgeons. Newport Beach, Calif, Jan 24, 1982.
Reprint requests to 5901 E Seventh St, Long Beach, CA 90822 (Dr Juler).
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