Fournier Gangrene

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ICD-9 Codes

728.86 – Necrotizing fasciitis

Synopsis

Fournier gangrene is the name given to necrotizing fasciitis involving the genital, perianal, or perineal regions. Gangrene results when the infection leads to thrombosis of the regional subcutaneous blood vessels. It is usually polymicrobial and results from trauma to the anogenital region (eg, surgical procedure) or spread of infection from nearby perineal structures (perianal glands, urinary tract infection, etc). Individuals with diabetes mellitus, chronic alcoholism, or who are otherwise immunosuppressed are at increased risk for Fournier gangrene. Men are affected much more frequently than women.

Fournier gangrene presents with pain, swelling, and erythema in the genital region and rapidly evolves to bullae formation and skin necrosis. There is often associated fever and lethargy. The mortality rate varies from 3–45%, and causes of death have included sepsis, coagulopathy, renal failure, diabetic ketoacidosis, and multiple organ failure.

Refer to Diagnostic Pearls for tips on distinguishing Fournier gangrene from cellulitis.

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