Definition of Fournier's gangrene

Fournier's gangrene: A horrendous infection of the genitalia that causes severe pain in the genital area (in the penis and scrotum or perineum) and progresses from erythema (redness) to necrosis (death) of tissue. Gangrene can occur within hours. The mortality (death) rates are up to 50%.

In this major medical emergency, a bacterial infection spreads quickly from the urinary tract (or the perianal, abdominal, or retroperitoneal areas), often following trauma. The gangrene is due to thrombosis of small blood vessels below the skin.

Fornier's gangrene has been thought to strike mainly men over 50. Today the disease is not limited to older males or to men (although women are less commonly affected than men). Fourier's gangrene can also occur in children from infancy to adolescence following such events as insect bites, trauma, burns, perirectal diseases and infections. Predisposing factors in all age ranges include diabetes, immunodeficiency and corticosteroid use.

Treatment is urgent. It involves surgically cutting away (debriding) the infected and necrotic (dead) tissue. Depending on the extent of the infection, surgical exploration of the abdomen and a colostomy also may be necessary. Triple-drug antibiotic therapy is given with, for example, Flagyl (metronidazole), ampicillin, and gentamicin.

The syndrome is named for Jean Alfred Fournier, a French venereologist (venereal disease specialist), who first described it in 1883.