Fournier Gangrene in 3 Years Old Patient with B Cell Acute Lymphoblastic Leukemia

Abstract

Fournier gangrene refers to necrotizing fasciitis localized to the genitalia, perineum, anus, and, occasionally, the skin of the lower abdomen. It is a life-threatening, rare infection of soft tissues and a medical emergency characterized by rapid onset of spreading inflammation and necrosis starting from the fascia, muscle, and subcutaneous fat, with subsequent necrosis of the overlying skin. Once suspected, immediate and extensive radical debridement of necrotic tissues is mandatory. Appropriate antibiotics and intensive general support avoid massive systemic infection and are the key to successful treatment. However, early diagnosis and management are missed or delayed in 85–100% of cases in large published series because of the lack of specific clinical features in the initial stage of the disease. It is often confused with cellulitis or abscess. B-cell acute lymphoblastic leukemia mainly affects children and young adults characterized by the rapid proliferation of poorly differentiated lymphoid progenitor cells inside the bone marrow.