Definition and Historical Perspective

Fournier's gangrene is a synergistic polymicrobial necrotizing fasciitis of the perineum and genitalia. It can progress to a fulminant soft tissue infection that spreads rapidly along the fascial planes, causing necrosis of the skin, subcutaneous soft tissue, and fascia, with associated systemic sepsis. If it is not diagnosed early and treated promptly, significant morbidity with prolonged hospital stay and even mortality will ensue.

In 1764, Baurienne described a fulminant gangrene of the male perineum. However, Jean Alfred Fournier, a French dermatologist and venereologist, became famous for this notorious condition when, in 1883, he described a series of five young men in whom gangrene of the genitalia occurred without any apparent etiologic factor. As knowledge of the condition increased over the years, it became clear that Fournier's gangrene is most common in older men (peak incidence in the 5th and 6th decades) and that most cases have an identifiable cause.

Fortunately, it is a rare condition, with a reported incidence of 1/7,500, and accounting for only 1 % - 2 % of urologic hospital admissions (Bejanga 1979; Bahlmann et al. 1983; Hejase et al. 1996). However, the incidence is rising, most likely due to an increase in the mean age of the population, as well as increased numbers of patients on immunosuppressive therapy or suffering from human immunodeficiency virus (HIV) infection, especially in Africa (McKay and Waters 1994; Elem and Ranjan 1995; Merino et al. 2001; Heyns and Fisher 2005).

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