Fourniers Gangrene

Contrary to the findings of the French venereologist after whom this condition is named, Fournier gangrene (often known as Fournier's gangrene or Fourniers gangrene) can also affect women and, very rarely, children.

However, it is ten times more likely to be found in men, especially the elderly who have a suppressed immune system.

In 60% of cases diabetes mellitus is also found to be present, approximately a third of patients will have alcoholism or malnutrition, and 10% will suffer with a compromised immune system through medical intervention - chemotherapy, HIV, steroids or cancer.

Fournier gangrene, is defined as a polymicrobial necrotising fasciitis of the perineal, perianal, or genital areas and normally develops when a mixture of bacteria and yeast microbes attack the body through a wound which becomes infected. Trauma, surgery or foreign bodies, along with chronic urinary tract infections,epididymitis, genital piercings, injections and implants have all been implicated as possible causes.

Because the testicular arteries are supplied directly by the aorta, the blood supply is separate from the infected region so the testes themselves are rarely affected.

This localised infection spreads to the surrounding tissue and the cultures act on the various layers of the skin, gradually destroying the fascia which connects everything together.

Symptoms commence with itching and discomfort of the external skin around scrotum but as it doesn't seem too severe and the pain sometimes diminishes as the disease progresses, sufferers do not always seek medical guidance quickly. By the time proper tests are carried out, the skin may have become gangrenous.

There may be symptoms of fever, lethargy and chills accompanied by increasing pain, redness and odour.

A full diagnosis will be made through physical examination and blood tests which will reveal the spongy, weeping, discolored skin to be gangrenous.

The condition should be treated as an emergency which will require intravenous antibiotics and thesurgical removal of the dead tissue. Teatments to inhibit and kill the bacteria will also be necessary because, if the dead tissue is not fully removed, it can continue to spread, entering the bloodstream and causing fatal complications. The condition tends to be fatal in 40% of cases but 78% of those who have the condition diagnosed after it has entered the bloodstream will perish from the side effects of sepsis.

It was originally named after a French venereologist called Jean-Alfred Fournier, who followed five young men with the symptoms and presented his findings in clinical lectures in 1883.

Historical figures of note who may well have been victims of this condition are Herod the Great and his grandson Herod Agrippa. The Roman emperor, Galerius, has also been mentioned in this connection.


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