What is Fournier’s gangrene?
Fournier’s gangrene is a rapidly progressing, tissue-destroying infection on the genitals and nearby areas. It’s a medical emergency that can be fatal without immediate treatment.
This infection is fatal in a third or more of people who contract it.
In Fournier’s gangrene, affected tissue dies and decomposes. The first symptom you’ll likely notice is sudden pain. The infection then progresses rapidly, and your skin develops a reddish-purple color or blue-gray patches.
As gangrene sets in, the decomposing tissue starts giving off a strong, rotten smell. Symptoms of an advanced infection include:
- swelling in the affected area
- rapid heartbeat
- high fever
In men, the infection can destroy their scrotum. That leaves their testes exposed.
Without prompt treatment, the infection can spread into the bloodstream and lead to organ failure and death.
Fournier’s gangrene is typically caused by one of three to four different kinds of bacteria. The bacteria damage blood vessels and produce toxins and enzymes that destroy tissue. The infection spreads along the connecting tissue between your skin and underlying muscles. It normally doesn’t harm the muscles.
The infection may start at a break in your skin, such as from an injury or surgery, which allows bacteria to infect your body. The infection commonly starts in the area between your genitals and rectum, known as the perineum, and spreads outward underneath your skin. It can also spread outside the genital area into your abdominal wall or buttocks.
Who gets it
The number of people who develop Fournier’s gangrene is unknown, but overall it’s rare. According to one estimate, about 1 in 7,500 people develop this condition, the majority of them men. It’s estimated that 97 people a year develop this condition.
Fournier’s gangrene is most commonly seen in men in their 60s or 70s. Certain health conditions that weaken your immune defenses can increase your risk for the infection. Up to 70 percent of people who develop the condition have diabetes and up to 50 percent have chronic alcoholism.
Fournier’s gangrene in women
The majority of people who develop Fournier’s gangrene are male, but the infection can happen in women. The site of the infection is often the external folds of tissue at the entrance to the vagina, known as the labia, and the area between the vagina and rectum, known as the perineum. Fournier’s gangrene may occur after a septic abortion or hysterectomy.
Fournier’s gangrene in children
Though it’s rare, children may develop Fournier’s gangrene. Contributing factors include:
Many conditions that weaken the body’s immune defenses can leave a person more vulnerable to Fournier’s gangrene. They include:
- treatment with immune-suppressing drugs
- Crohn’s disease
- HIV infection
- long-term treatment with corticosteroid drugs
- liver disease
- severe (morbid) obesity
- advanced age
Accurately diagnosing Fournier’s gangrene usually requires a tissue sample. Your doctor takes a sample of the infected tissue and then sends it to a lab for testing. A lab technician runs tests to identify microbes and look for signs that can rule out other types of infections. Blood tests also help in the diagnosis.
Your doctor may also use medical imaging to help them diagnose Fournier’s gangrene and rule out other possibilities. Medical imaging may include:
Your doctor will administer multiple antibiotics to treat the underlying bacterial infection. You’ll also need surgery to completely remove dead or dying tissue. This is known as debridement. You’ll likely need multiple surgeries to remove all of the dead tissue and stop the infection. People who are only treated with antibiotics and don’t have debridement rarely survive.
If diabetes, alcohol abuse, or other illnesses are contributing factors, those will also need to be treated.
You’ll likely need reconstructive plastic surgery and skin grafts to cover the areas where dead tissue was removed.
About half of people who survive Fournier’s gangrene experience chronic pain. Men may have painful erections or other types of sexual difficulties following this condition.
Fournier gangrene is often fatal. It’s estimated that 20-30 percent of cases are fatal. The typical causes of death are spread of the infection into the bloodstream, which is known as sepsis, kidney failure, or multiple organ failure. Prompt surgery to completely remove tissue and aggressive antibiotics can reduce the chance of death.
Q&A: Is Fournier’s gangrene an STD?
Is Fournier’s gangrene contagious? Can I catch it from a sexual partner?
Fournier’s gangrene is generally not considered contagious. It’s usually caused by organisms that are in the gastrointestinal tract. The bacteria require an entrance into the skin, usually by local trauma to the genital region. There will be an open wound in this region, and bacteria will be present. If a person comes into contact with the secretions from the wound, and these secretions then come into contact with an open wound, they could become infected. This is the only way in which it could be transmitted to a sexual partner. Sterile technique needs to be followed when dealing with a person who has these wounds.William Morrison, MDAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.