| Fournier's gangrene | |
|---|---|
| Classification and external resources | |
| ICD-10 | N49.8 (ILDS N49.81), N76.8 |
| ICD-9 | 608.83 |
| DiseasesDB | 31119 |
| eMedicine | emerg/929 med/2814 |
| MeSH | D018934 |
Fournier's gangrene is a type of necrotizing infection or gangrene usually affecting the perineum.
It was first described by Baurienne in 1764 and is named after a French venereologist, Jean-Alfred Fournier following five cases he presented in clinical lectures in 1883.
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In the majority of cases Fournier's gangrene is a mixed infection caused by both aerobic and anaerobic bacteria.[1]
Fournier's gangrene is a urological emergency requiring intravenous antibiotics and debridement (surgical removal) of necrotic (dead) tissue. In addition to surgery and antibiotics, hyperbaric oxygen therapy (HBO) may be useful and acts to inhibit the growth of and kill the anaerobic bacteria.[2] Despite such measures, the mortality rate overall is 40%, but 78% if sepsis is already present at the time of initial hospital admission.[3]
The most historically prominent sufferers from this condition may have been Herod the Great, his grandson Herod Agrippa, and possibly the Roman emperor Galerius. Puerto Rican abolitionist and pro-independence leader Segundo Ruiz Belvis died from Fournier gangrene in 1868.
An estimated 750 cases have been reported in the literature,[4] with most patients in their 60s or 70s with other concurrent illnesses.[5] However, Fournier's gangrene is not a reportable illness, so the number of unreported cases is unclear. A similar infection in women has been occasionally described.[6]
In Turkey it was reported that 46% of patients had diabetes mellitus[3] while other studies have identified approximately a third of patients having either diabetes, alcoholism or malnutrition, and 10% having medical immunosuppression (chemotherapy, steroids, malignancy).[7]
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