Canadian Medical Association Fournier's gangrene is a polymicrobial synergistic necrotizing infection of the perirectal, perineal or genital area. Anorectal disorders, genitourinary infections and traumatic injuries are the most common causes. The patient usually presents with erythema, pain and swelling. The skin manifestations may not represent the true extent of the infection, which moves aggressively along fascial planes. Also, the patient usually has systemic signs such as fever, hypotension, tachycardia and leukocytosis.
Initial treatment requires volume resuscitation and initiation of broad-spectrum antibiotics.
Fig.3 is an operative view in the case of a patient who was fortunate to have his scrotum and musculature spared by immediate surgery. In the majority of cases, the testes, glans penis, bladder and rectum are spared because they have a separate blood supply. Urinary and fecal diversion may be required. A reappraisal of surgical management in necrotizing perineal infections. Laucks SS 2d.