[Fournier's disease. Clinical case].

Area of Science:

• Urology
• Infectious Diseases

Background:

• Fournier's disease is a severe necrotizing fasciitis predominantly affecting the male perineal region.
• It is considered a urological emergency due to potential sepsis, systemic organ impairment, and high mortality.
• Common predisposing factors include urethral/anorectal infections, immunodeficiency, diabetes mellitus, and trauma.

Observation:

• This case involved Fournier's disease with gangrenous necrotic evolution in the perineal area.
• The infection presented as a mixed aerobic and anaerobic bacterial process, leading to tissue necrosis via immunovasculitis.
• Management included antibiotic therapy, surgical debridement of necrotic tissue, and local disinfection.

Findings:

• Aggressive management with antibiotic therapy, meticulous wound care, and total parenteral nutrition achieved perineal decontamination.
• Extensive scrotal tissue loss was successfully reconstructed within 25 days.
• The anal wound demonstrated spontaneous healing following complete surgical curettage.

Implications:

• This case highlights the critical importance of early recognition and aggressive multidisciplinary management for Fournier's disease.
• Effective treatment strategies, including surgical intervention and supportive care, can significantly improve patient outcomes.
• Successful reconstruction and wound healing are achievable even with extensive tissue loss in Fournier's disease.