Abstract
The French venereologist Jean Alfred Fournier reported the first small series of a rapidly progressive gangrene of the penis and scrotum in five young men in 1883. The underlying polymicrobial necrotizing fasciitis starts in the perineal, perianal, or genital areas and can extend up to the abdominal and lumbar wall. It is most common in older men in the 5th–6th decades and associated with diseases which precondition an immunodeficiency status like diabetes mellitus, malnutrition, chronic alcoholism, and malignant or infectious diseases. Although the incidence is low and accounts for less than 0.5 % of all admissions to urologic clinics, the incidence is rising due to an increase of older people with higher comorbidities and limited immunologic status [1]. The restricted immunity together with an anorectal, urogenital, or perineal trauma is often associated with recent instrumentation and enables microorganisms, such as Enterobacteriaceae; anaerobic, streptococcal, and staphylococcal species; or fungi, to promote the fulminant infection of a Fournier’s gangrene [2]. Especially, synergistic polymicrobial effects lead to a rapid spread along the superficial and deep fascial planes. Gangrenous necrosis of the fascia is followed by the involvement of adjacent subcutaneous and skin tissue [3]. Delayed treatment leads to a rapid systemic progression with fulminant sepsis, multiorgan failure, and high mortality of up to 70 % despite rapid operation and modern intensive care therapy [4].
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References
Altarac S, Katusin D, Crnica S, Papes D, Rajkovic Z, Arslani N. Fournier’s gangrene: etiology and outcome analysis of 41 patients. Urol Int. 2012;88:289–93.
Yanar H, Taviloglu K, Ertekin C, Guloglu R, Zorba U, Cabioglu N, Baspinar I. Fournier’s gangrene: risk factors and strategies for management. World J Surg. 2006;30:1750–4.
Mallikarjuna MN, Vijayakumar A, Patil VS, Shivswamy BS. Fournier’s gangrene: current practices. ISRN Surg. 2012;2012:942437.
Sugihara T, Yasunaga H, Horiguchi H, Fujimura T, Ohe K, Matsuda S, Fushimi K, Homma Y. Impact of surgical intervention timing on the case fatality rate for Fournier’s gangrene: an analysis of 379 cases. BJU Int. 2012;110:E1096–100.
Roghmann F, von Bodman C, Loppenberg B, Hinkel A, Palisaar J, Noldus J. Is there a need for the Fournier’s gangrene severity index? Comparison of scoring systems for outcome prediction in patients with Fournier’s gangrene. BJU Int. 2012;110:1359–65.
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© 2014 Springer-Verlag Berlin Heidelberg
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Kruck, S., Bedke, J. (2014). Fournier’s Gangrene. In: Merseburger, A., Kuczyk, M., Moul, J. (eds) Urology at a Glance. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-54859-8_66
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DOI: https://doi.org/10.1007/978-3-642-54859-8_66
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