Genital / perineal necrotizing fasciitis - Fournier's gangrene

Medium urgency
-Moderately severe

This is an infection located in the genital area, perineum and/or anus caused by bacteria. It affects soft tissues beneath the skin and its fasciae.

Contributing factors to this infection have been described, such as alcoholism, diabetes, HIV, kidney failure, cancer and malnutrition.

Symptoms include fever, genital pain, swelling and redness of the affected area. Later observable events include areas of dead skin, foul odor, purulent exudate and crackling when palpating the skin. In a few hours, the infection becomes widespread, with multiple organ failure and death.

It is diagnosed through medical history collection, physical examination, blood tests, cultures and CT-scan.

Medical treatment must be started early, with intravenous antibiotic, strong pain killers and good intravenous hydration, followed by urgent surgical treatment to remove any and all devitalized tissue.

Bibliographic references
  1. Dennis L Stevens, Larry M Baddour. Necrotizing soft tissue infections. UpToDate. Aug 04, 2016.
  2. Resman F, Svensjö T, Ünal C, et al. Necrotizing myositis and septic shock caused by Haemophilus influenzae type f in a previously healthy man diagnosed with an IgG3 and a mannose-binding lectin deficiency. Scand J Infect Dis 2011; 43:972.
  3. Hau V, Ho CO. Necrotising fasciitis caused by Vibrio vulnificus in the lower limb following exposure to seafood on the hand. Hong Kong Med J 2011; 17:335.
  4. Darenberg J, Luca-Harari B, Jasir A, et al. Molecular and clinical characteristics of invasive group A streptococcal infection in Sweden. Clin Infect Dis 2007; 45:450.
  5. Anaya DA, Dellinger EP. Necrotizing soft-tissue infection: diagnosis and management. Clin Infect Dis 2007; 44:705.
  6. Stephens DL. Infecciones de la piel, músculo y partes blandas. Harrison. Manual de Medicina. 16º edición. 428-432.
Author
Dr. Elvira Moreno
Copyright
© TeckelMedical 2026

Symptoms

    Fever / Feel very hot


    Scrotum has become darker


    Anal discomfort


    Pain above the pubis


    Testicular pain

Pre-hospital care recommendations

Take over-the-counter pain relievers or anti-inflammatories.
Maintain a fluid intake of 6 - 8 cups per day.