Fournier’s Gangrene: Diagnostic and Therapeutic Considerations

Fournier’s gangrene is a necrotising fasciitis of the genitalia. Jean Alfred Fournier (18321914) was the first French syphilologist, the first professor of cutaneous and syphilitic diseases at the Paris Faculty of Medicine, and the most prominent European venereologist of the second half of the 19th century. He first described idiopathic, rapily progressive necrotizing gangrene of the male genitalia in 1883 and emphasised three characteristics; abrupt onset of scrotal pain and swelling in a healthy young man, rapid progression to gangrene, and the absence of a definitive cause (Fournier, 1883). Fournier’s original description included five otherwise healthy young males with scrotal gangrene and emphasised the sudden onset and rapid progression of the disease. Over the years several terms have been applied to Fournier’s gangrene including ‘streptococcus gangrene’, ‘necrotising fasciitis’, ‘periurethral phlegmon’, ‘phagedena’ and ‘synergistic necrotising cellulitis’ (Eke, 2000). Although originally described in healthy young men Fournier’s gangrene is frequently seen in elderly patients as well as children (Woodside, 1980) and women (Lowthian and Gillard Jr, 1980).