Female Fournier’s gangrene: not just a flesh-eating disease of scrotum

Authors

  • Amulya Aggarwal Department of Urology, Rajarajeswari Medical College and Hospital, Bangalore, Karnataka, India https://orcid.org/0009-0009-2164-911X
  • Srinath N. Department of Urology, Rajarajeswari Medical College and Hospital, Bangalore, Karnataka, India
  • Prathvi Shetty Department of Urology, Rajarajeswari Medical College and Hospital, Bangalore, Karnataka, India
  • Megha Gupta Department of Critical Care, Glenegles BGS Hospital, Bangalore, Karnataka, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20251003

Keywords:

Polymicrobial, Necrosis, Female Fournier’s gangrene

Abstract

Fournier’s gangrene (FG) is a severe, rapidly progressing, and potentially life-threatening soft tissue infection that primarily affects the genital, perineal, or perianal regions. Fournier’s gangrene in female is considered to be a rare case scenario. The pathogenesis of FG involves a synergistic polymicrobial infection, typically originating from a focus in the genitourinary tract, anorectal region, or surrounding soft tissues of the genital area. The most common initial symptom is pain in the perineal or perianal region. If not promptly treated, the infection can rapidly extend through fascial planes to areas such as the buttocks, abdominal wall, pelvis, and retroperitoneum. Misdiagnosis may delay surgical intervention and increase the risk of mortality. We had a case of female Fournier’s gangrene with no comorbidities presented at a younger age and managed surgically with serial debridement under antibiotic coverage followed by secondary suturing. Prompt surgical intervention resulted in good recovery of patient with cosmetically satisfactory scar. The key to a favorable prognosis lies in timely diagnosis, early surgical intervention, targeted antimicrobial therapy, wound care, and comprehensive supportive management.

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References

Kaul R, McGeer A, Low DE, et al. Population based surveillance for group A streptococcal necrotizing fasciitis: clinical features, prognostic indicators, and microbiologic analysis of seventy-seven cases. Ontario Group A Streptococcal Study. Am J Med 1997; 103:18–24. DOI: https://doi.org/10.1016/S0002-9343(97)00160-5

Fournier J A. Jean-Alfred Fournier 1832–1914. Gangrene foudroyante de la verge (overwhelming gangrene). Sem Med 1883. Dis Colon Rectum 1988; 31:984–8. DOI: https://doi.org/10.1007/BF02554904

Wilson B. Necrotizing fasciitis. Am Surg 1952; 18:416-431.

Gurdal M. Predisposing factors and treatment outcome in Fournier’s gangrene. Urol Int 2003;70(4):286-90. DOI: https://doi.org/10.1159/000070137

Yaghan RJ. Fournier’s gangrene: changing face of the disease. Dis Colon Rectum 2000; 43(9):1300-8. DOI: https://doi.org/10.1007/BF02237442

Sherman J. Early CT findings of Fournier’s gangrene in a healthy male. Clin Imaging 1998; 22(6):425-7. DOI: https://doi.org/10.1016/S0899-7071(98)00073-4

Vick R. Fournier’s gangrene. Urol Clin North Am 1999; 26(4):841-9. DOI: https://doi.org/10.1016/S0094-0143(05)70224-X

Taylor GM, Hess DV. Fournier gangrene: a rare case of necrotizing fasciitis of the entire right hemi-pelvis in a diabetic female. Oxf Med Case Reports 2018; 2018:omx094. DOI: https://doi.org/10.1093/omcr/omx094

Corman JM. Fournier’s gangrene in a modern surgical setting: improved survival with aggressive management. BJU International. 1999;84:85-8. DOI: https://doi.org/10.1046/j.1464-410x.1999.00140.x

Fillo J. Fournier’s gangrene: Can aggressive treatment save life. Int Urol Nephrol. 2001;33(3):533-6. DOI: https://doi.org/10.1023/A:1019554327341

Eke N. Fournier’s gangrene: a review of 1726 cases. Br J Surg 2002; 87(6):718-28. DOI: https://doi.org/10.1046/j.1365-2168.2000.01497.x

Yucel M, Ozpek A, Başak F. Fournier’s gangrene: A retrospective analysis of 25 patients. Ulus Travma Acil Cerrahi Derg. 2017;23:400–4. DOI: https://doi.org/10.5505/tjtes.2017.01678

Sorensen MD, Krieger JN, Rivara FP, Joshua A, Broghammer JA, Klein MB, et al. Fournier's Gangrene: Population Based Epidemiology and Outcomes in 1970 cases. J Urol. 2009;181(5):2120-6. DOI: https://doi.org/10.1016/j.juro.2009.01.034

Hejase MJ, Simonin JE, Bihrle R, Coogan CL. Genital Fournier’s gangrene: experience with 38 patients. Urol. 1996;47:734-9. DOI: https://doi.org/10.1016/S0090-4295(96)80017-3

Ayumba BR, Magoha GA. Epidemiological aspects of Fournier’s gangrene at Kenyatta National Hospital, Nairobi. East Afr Med J. 1998;75:586-9.

Brissiaud JC, Azam P, Paret B, Lopy J, Louis C, Collet F. Skin gangrene of the external genitalia. Report of 44 cases. Chirurgie. 1998;123:387-93. DOI: https://doi.org/10.1016/S0001-4001(98)80010-X

Benchekroun A, Lachkar A, Bjijou Y. Gangrene of the external genital organs. Apropos of 55 cases. J Urol. 1997;103:27-31.

Benizri E, Fabiani P, Migliori G. Gangrene of the perineum. Urol. 1996;47:935-9. DOI: https://doi.org/10.1016/S0090-4295(96)00058-1

Ghnnam WM. Fournier’s gangrene in Mansoura Egypt: a review of 74 cases. J Postgrad Med. 2008;54:106-9. DOI: https://doi.org/10.4103/0022-3859.40776

Carvalho JP, Hazan A, Cavalcanti AG. Relation between the area affected by Fournier’s gangrene and the type of reconstructive surgery used. A study with 80 patients. Int Braz J Urol. 2007;33:510-4. DOI: https://doi.org/10.1590/S1677-55382007000400008

Lancerotto L, Tocco I, Salmaso R, Vindigni V, Bassetto F. Necrotizing fasciitis: classification, diagnosis, and management. J Trauma Acute Care Surg. 2012;72(3):560-6. DOI: https://doi.org/10.1097/TA.0b013e318232a6b3

Davoudian P, Flint NJ. Necrotizing fasciitis: Cont Edu Anaesth Crit. Care and Pain. 2012;12(5):245-50. DOI: https://doi.org/10.1093/bjaceaccp/mks033

Yi Y, Wang J, Kong L, Keeran SJM, Wu T, Zhang Z. Lemiere syndrome caused by Arcanobacterium hemolyticum. Chin Med J. 2013;126:391-2. DOI: https://doi.org/10.3760/cma.j.issn.0366-6999.20122805

Dos-Santos DR, Roman ULT, Westphalen AP, Lovison K, Spencer Neto FAC. Profile of patients with Fournier’s gangrene and their clinical evolution. Rev Col Bras Cir. 2018;45:1430. DOI: https://doi.org/10.1590/0100-6991e-20181430

Voelzke BB, Hagedorn JC. Presentation and Diagnosis of Fournier Gangrene. Urol. 2018;114:8–13. DOI: https://doi.org/10.1016/j.urology.2017.10.031

Hsu JM, Chen M, Weng CH, Tseng JS. Fournier’s Gangrene: clinical characteristics in the elderly. International J of Gerontol. 2014;8:162–5. DOI: https://doi.org/10.1016/j.ijge.2013.08.013

Wong CH, Chang HC, Pasupathy S, Khin LW, Tan JL, Low CO. Necrotizing fasciitis: clinical presentation, microbiology, and determinants of mortality. J Bone Joint Surg Am. 2003;85:1454–60. DOI: https://doi.org/10.2106/00004623-200308000-00005

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Published

2025-03-29

How to Cite

Aggarwal, A., N., S., Shetty, P., & Gupta, M. (2025). Female Fournier’s gangrene: not just a flesh-eating disease of scrotum. International Journal of Research in Medical Sciences, 13(4), 1704–1707. https://doi.org/10.18203/2320-6012.ijrms20251003

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Case Reports