Necrotizing infection of scrotum

Fournier's gangrene: A general surgery problem

“…Only 37 additional cases had been reported through 1976 [16]. We have found another 15 cases added to the literature in the last 6 years [4,18]. The appearance of antibiotics was presumed to be responsible for this apparent change in incidence [ll, 16].…”

“…Fournier described all of his cases as being without known precipitating causes and he postulated a septic etiology [1,2]. Previous authors have found Perforated colonic diverticula Pancreatitis approximately 50% of cases to fall into an idiopathic category [13,18,19]. Bacterial involvement is clinically evident, but proof of its being the inciting cause is lacking.…”

“…The condition, since known as Fournier's gangrene, has also been referred to as synergistic gangrene [3,4], idiopathic gangrene [5][6][7][8], streptococcal cellulitis of the scrotum [9], essential gangrene, scrotal gangrene, or fulminating gangrene [10][11][12]. Sporadic cases and reviews have appeared predominantly in the urologic and plastic surgical literature [4,5,[13][14][15][16][17][18][19][20][21]. Three hundred cases were reported between 1884 and 1938 [16], after which the incidence appeared to drop precipitously.…”

“…Loose folds of skin may serve as a nidus for organisms that can then penetrate in the presence of minor trauma [10, 1 l]. This would explain the role some have attributed to general uncleanliness [18,24]. Perhaps the transverse rugae prevent free circulation and thus impair resistance to bacteria that may be present, as well as the evaporation of sweat.…”

Acute Gangrene of the Scrotum and Penis in a Patient with Acute Promyelocytic Leukemia

“…the occurrence of Fournier's gangrene has not been described, to our knowledge, even in large series of infections in acute leu kemia [7], In our patient a micro-organism was isolated from the lesion and from several blood cultures nearly at the same time; the Pseudomonas had the same strict antibiotic sensitivity, thus suggesting it to be the same germ. Previous work has reported a wide range of organisms isolated from the necrot ic lesion, but Pseudomonas was only an oc casional finding [2].…”