Fournier’s Gangrene – Causes, Symptoms, Diagnosis and Treatment

Suffering from pain and swelling in the penis and the surrounding skin region? Having redness in the skin area around your genitals? Get in touch with a doctor immediately for you may be having a condition called Fournier Gangrene.

What Is Fournier’s Gangrene?

Fournier Gangrene is a type of Gangrene characterized by the necrosis of cells around the penis. The term ‘necrosis’ refers or death of living cells in a localized region of the body. Fournier Gangrene is a serious medical condition and it leads to death of a sufferer if not treated in time. This is why Fournier Gangrene is seen as a medical emergency.

Fournier Gangrene History

Fournier Gangrene was first described in 1764 by Baurienne. But it was reported in detail in 1883 by Jean-Alfred Fournier, a French Venerologist. He reported about the condition in five young healthy male and presented it in his medical lectures. This is the reason why the disease has been named after him.

Fournier Gangrene Symptoms

Fournier Gangrene gives rise to symptoms like :

Necrosis

Necrosis of cells in the genitalia is the main symptom of this disorder. There is localized death of the cells in and around the penis. The cells in the genital area and also in the perineal area (the region between the anus and genital organs) quickly begin getting destroyed.

Acute Pain

There is intense pain in the genital region. The entire area feels tender to touch.

Redness

The genitalia turn red in appearance. Redness is one of the early symptoms of this condition.

Inflammation

The region also suffers an inflammation as the tissues underlying it begin to swell. The inflammation persists and becomes highly discomforting.

Compactness

Sufferers also feel tightness in the genitalia and perineal region. This is due to stretching of skin in the penis area.

Fever

Patients of this condition also suffer from higher body temperatures. This usually lasts anywhere between 2 days and a week.

Dusky Appearance

The skin covering the genitalia becomes dusky in appearance.

Who Gets Fournier Gangrene?

Fournier Gangrene typically affects men above 50 years of age. Fournier Gangrene in women is less common. In Fournier Gangrene females suffer much less than males. It generally affects male groin and genital area.

Alcoholics and obese people are at great risk from this disease. Individuals with weakened immunity and chronic diseases such as diabetes are highly likely to develop this complication.

The disease also affects people who have undergone a surgery or suffered an injury in the Perigenital area. It is also seen in individuals with Paraphimosis or Urethral injury.

Fournier Gangrene Causes

Fournier Gangrene is thought to be a case of mixed infection. It is caused by infection by both anaerobic bacteria such as Clostridium and Fusobacterium and aerobic bacteria like Klebsiella, E. coli and Enterococci. This usually arises from an underlying infection like Urinary Tract Infection (UTI).

Fournier Gangrene Complications

If Fournier Gangrene is left untreated, the infected tissues in the perineal and genital regions begin to die. The skin becomes dark and discolored with red sores appearing over the whole area. If the infection enters the bloodstream, it can give rise to a number of complications which can even result in death of the sufferer.

Fournier Gangrene Diagnosis

The diagnosis of Fournier Gangrene involves carrying out blood tests. Routine laboratory tests are done to find out if there is sepsis involved.

In many people with Fournier Gangrene Ultrasound Tests are recommended to gauge the extent of thickness of the scrotal wall. Ultrasound Imaging of the Scrotum is needed to detect Testicular Infection, Epididymitis or trapped air in tissues of the scrotum. Trapped air in scrotal tissues is an indication of the extent of Fournier Gangrene.

If doctors suspect a colorectal origin of the Fournier Gangrene CT scans may be required.

Fournier Gangrene Differential Diagnosis

The differential diagnosis for Fournier Gangrene involves differentiating the condition from other diseases like Epididymitis and Testicular Tumors that give rise to similar symptoms.

Fournier Gangrene Treatment

The treatment of Fournier Gangrene involves :

Antibiotics

Immediate use of antibiotic medicines is needed to stop progress of infection. A combination of antibiotic drugs like Metronidazole, Gentamicin and Cephalosporin is needed to treat the infection.

Fournier Gangrene Debridement

A surgery is immediately needed to remove infected and dead tissues in the region. Leaving an infected tissue un-operated can cause greater necrosis in the genitalia and spread the infection to other areas of the body.

An expert surgeon tries to remove the maximum amount of infected tissue to avoid complications. Orchiectomy or removal of one of the testes is required very rarely. A radical surgery, which requires complete removal of necrotic tissue in the affected area, is usually enough to treat the infection.

A Fournier Gangrene Debridement or Surgical Removal usually changes the appearance and size of the genital region. A surgical reconstruction is needed to restore shape to the genital.

Hyperbaric Oxygen Therapy (HBO)

Apart from antibiotic and surgical treatment, Hyperbaric Oxygen Therapy (HBO) can also be effective in destroying and reducing anaerobic bacterial growth in the localized region.

Fournier Gangrene Mortality

Fournier Gangrene is a deadly syndrome. Time is the most important factor in the treatment of Fournier Gangrene. Mortality rate is about 40% in case of this disorder. However, the rate of expiration can be as high as 78% if a sufferer has Sepsis during the time of hospitalization itself.

If anyone in your family is suffering from Fournier Gangrene or you are having symptoms of the disease yourself, you should immediately call up a doctor without wasting a second. Fournier Gangrene is a life-threatening condition and it makes sense that you let go of all inhibitions and confide in a doctor before time runs out for you. Every second counts when you have a syndrome like this and the faster you act the easier will it be to get cured from the disease.

References:

http://www.urology-textbook.com/fournier-gangrene.html

http://www.wisegeek.com/what-is-fournier-gangrene.htm

http://www.ncbi.nlm.nih.gov/pubmed/7985069

http://radiopaedia.org/articles/fournier-gangrene

http://www.wrongdiagnosis.com/f/fournier_gangrene/intro.htm