Fournier's gangrene is a type of necrotizing

Necrosis

Necrosis is the premature death of cells in living tissue. Necrosis is caused by factors external to the cell or tissue, such as infection, toxins, or trauma. This is in contrast to apoptosis, which is a naturally occurring cause of cellular death...

 infection

Infection

An infection is the colonization of a host organism by parasite species. Infecting parasites seek to use the host's resources to reproduce, often resulting in disease...

 or gangrene

Gangrene

Gangrene is a serious and potentially life-threatening condition that arises when a considerable mass of body tissue dies . This may occur after an injury or infection, or in people suffering from any chronic health problem affecting blood circulation. The primary cause of gangrene is reduced blood...

 usually affecting the perineum

Perineum

In human anatomy, the perineum is a region of the body including the perineal body and surrounding structures...

.

It was first described by Baurienne in 1764 and is named after a French venereologist

Venereology

Venereology is a studio album by the Japanese noise musician Merzbow. It was the first of five Merzbow albums released by the American heavy metal label Relapse Records, under their Release Entertainment imprint, and as such was responsible for bringing Merzbow's work to a much wider audience in...

, Jean-Alfred Fournier following five cases he presented in clinical lectures in 1883.

Cause

In the majority of cases Fournier's gangrene is a mixed infection caused by both aerobic

Aerobic organism

An aerobic organism or aerobe is an organism that can survive and grow in an oxygenated environment.Faculitative anaerobes grow and survive in an oxygenated environment and so do aerotolerant anaerobes.-Glucose:...

 and anaerobic

Anaerobic organism

An anaerobic organism or anaerobe is any organism that does not require oxygen for growth. It could possibly react negatively and may even die if oxygen is present...

 bacteria.

Treatment

Fournier's gangrene is a urological emergency requiring intravenous antibiotics and debridement

Debridement

Debridement is the medical removal of a patient's dead, damaged, or infected tissue to improve the healing potential of the remaining healthy tissue...

 (surgical removal) of necrotic (dead) tissue. In addition to surgery and antibiotics, hyperbaric oxygen therapy

Hyperbaric oxygen therapy

Hyperbaric medicine, also known as hyperbaric oxygen therapy , is the medical use of oxygen at a level higher than atmospheric pressure. The equipment required consists of a pressure chamber, which may be of rigid or flexible construction, and a means of delivering 100% oxygen...

 (HBO) may be useful and acts to inhibit the growth of and kill the anaerobic bacteria. Despite such measures, the mortality rate overall is 40%, but 78% if sepsis

Sepsis

Sepsis is a potentially deadly medical condition that is characterized by a whole-body inflammatory state and the presence of a known or suspected infection. The body may develop this inflammatory response by the immune system to microbes in the blood, urine, lungs, skin, or other tissues...

 is already present at the time of initial hospital admission.

The most historically prominent sufferers from this condition may have been Herod the Great

Herod the Great

Herod , also known as Herod the Great , was a Roman client king of Judea. His epithet of "the Great" is widely disputed as he is described as "a madman who murdered his own family and a great many rabbis." He is also known for his colossal building projects in Jerusalem and elsewhere, including his...

, his grandson Herod Agrippa, and possibly the Roman emperor

Roman Emperor

The Roman emperor was the ruler of the Roman State during the imperial period . The Romans had no single term for the office although at any given time, a given title was associated with the emperor...

 Galerius

Galerius

Galerius , was Roman Emperor from 305 to 311. During his reign he campaigned, aided by Diocletian, against the Sassanid Empire, sacking their capital Ctesiphon in 299. He also campaigned across the Danube against the Carpi, defeating them in 297 and 300...

. Puerto Rican abolitionist

Abolitionism

Abolitionism is a movement to end slavery.In western Europe and the Americas abolitionism was a movement to end the slave trade and set slaves free. At the behest of Dominican priest Bartolomé de las Casas who was shocked at the treatment of natives in the New World, Spain enacted the first...

 and pro-independence leader Segundo Ruiz Belvis

Segundo Ruiz Belvis

Segundo Ruiz Belvis , was a dedicated abolitionist who also fought for Puerto Rico's right to independence.-Early years:...

 died from Fournier gangrene in 1868.

Epidemiology

An estimated 750 cases have been reported in the literature, with most patients in their 60s or 70s with other concurrent illnesses. However, Fournier's gangrene is not a reportable illness, so the number of unreported cases is unclear. A similar infection in women has been occasionally described.

In Turkey it was reported that 46% of patients had diabetes mellitus

Diabetes mellitus

Diabetes mellitus, often simply referred to as diabetes, is a group of metabolic diseases in which a person has high blood sugar, either because the body does not produce enough insulin, or because cells do not respond to the insulin that is produced...

while other studies have identified approximately a third of patients having either diabetes, alcoholism or malnutrition, and 10% having medical immunosuppression (chemotherapy, steroids, malignancy).

External links

and