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FOURNIER'S gangrene: the development of a classical pathology

Ayhan Verit1, Fatma Ferda Verit

  • 1Department of Urology, School of Medicine, Harran University, Sanliurfa, Turkey.

BJU International
|October 10, 2007
PubMed

Insights

Fournier's gangrene (FG), a severe necrotizing fasciitis, is evolving with atypical presentations and changing causative organisms. Future treatments may shift away from hyperbaric oxygen therapy as FG becomes less fatal.

Area of Science:

  • Infectious Diseases
  • Dermatology
  • Surgical Pathology

Background:

  • Necrotizing fasciitis, particularly Fournier's gangrene (FG) originating in the perineum, is a rare but aggressive subcutaneous infection.
  • Despite being known for over a century, established medical principles for managing FG have seen limited evolution.
  • Recent observations suggest a metamorphosis in the clinical presentation and understanding of this enigmatic pathology.

Purpose of the Study:

  • To review recent literature on Fournier's gangrene (FG).
  • To discuss novel aspects in the evaluation and clinical progression of FG.
  • To speculate on the future trends in FG management and outcomes.

Main Methods:

  • A comprehensive review of English-language reports concerning Fournier's gangrene (FG).
  • Analysis of clinical characteristics, predisposing factors, and microbial etiology.
  • Examination of treatment modalities and prognostic indicators.

Main Results:

  • Increasing incidence of atypical FG locations (e.g., head and neck) and patients without predisposing factors.
  • Declining role of anaerobic bacteria, with a concurrent rise in atypical organisms.
  • Observed changes in the clinical presentation and microbial landscape of FG.

Conclusions:

  • Fournier's gangrene (FG) exhibits evolving clinical characteristics and microbial profiles.
  • Hyperbaric oxygen therapy may become less prevalent due to shifts in causative agents.
  • The prognosis for FG is improving, with a projected decrease in mortality rates.

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