Four cases of recreation of the scrotum with meshed split thickness skin grafts (STSG) are presented. The discussion includes a comparison of STSG with other treatment options. [ucdavis.pure.elsevier.com]

We report on 3 heroin abusers who presented with localized gangrene of the genitalia after injection into the femoral vessels. [ncbi.nlm.nih.gov]

The perineum presents an ample anastomotic network of blood vessels, similar to the face, which allows for the establishment of several flaps. [rbcp.org.br]

Fournier's Gangrene Presenting as Gas-forming Subcutaneous Infection of the Scrotum. Scand J Urol Nephrol. 1983;17(2):245-7. PubMed PMID: 6612244. TY - JOUR T1 - Fournier's gangrene presenting as gas-forming subcutaneous infection of the scrotum. [unboundmedicine.com]

Patients presenting with acquired immunodeficiency syndrome also present a higher predisposition to the disease (2). [scielo.br]

• Rectal Pain

  CASE: Fournier’s Gangrene FACTS/LIABILITY: 51-year old male plaintiff was treated by the defendant, internist for severe rectal pain and itching. [reiskirkland.com]

• Ulcer

  It was characterized by an acute onset of skin ulcers undergoing complete resolution after appropriate therapy, with no relapses. [ncbi.nlm.nih.gov]

  Ulcerated granulation tissue is shown. The arrow points to absent epidermis, indicating ulceration. Sections of hyper- and parakeratotic scrotal skin gave way to extensive ulceration. [jmedicalcasereports.biomedcentral.com]

  In addition, superoxidized water is highly effective in treating infectious skin conditions and refractory ulcers associated with diabetes mellitus or peripheral circulatory insufficiency [6]. [academic.oup.com]

  The glans penis was unaffected by ulceration and only mildly affected by edema. Ulceration occurred on the dorsum of the mid penile shaft in all patients. [njcponline.com]

• Erythema

  Edema, erythema, and pain settled over the following 48 hours. Wound cultures revealed Enterococcus sp. (ampicillin-sensitive) and Staphylococcus aureus (methicillin-sensitive). [jmedicalcasereports.biomedcentral.com]

  Examination of the patient's perineum was consistent with Fournier's gangrene and included significant erythema, edema, and calor of the penis and scrotum with a large malodorous eschar. [hindawi.com]

  […] promote anaerobes and cause rapid dissemination Obliterative endarteritis plays a key role in pathogenesis Diagrams / tables Images hosted on other servers: Fournier gangrene severity index Clinical features Patients present with genital induration, pain, erythema [pathologyoutlines.com]

  Mortality rate remains high at 20% to 40% despite improvements in medical care (3) clinical findings include fever, pain and swelling, erythema or dark discoloration, discharge from the wound, induration, and crepitus of the affected area key component [gpnotebook.com]

  Clinical Examination Examination of the scrotum/perineum may reveal: Erythema, possibly macerated or necrotic tissue in late stages Swelling/oedema Tenderness Subcutaneous crepitus Dusky appearance of skin Obvious gangrene Fournier Gangrene Severity Index [aci.health.nsw.gov.au]

• Blister

  At first, tissue affected by moist gangrene has the color of a bad bruise, is swollen, and often blistered. The gangrene is likely to spread with great speed. Toxins are formed in the affected tissues and absorbed. [medical-dictionary.thefreedictionary.com]

  Fatigue Redness and inflammation Edema Fluid drainage Soft tissue gas Graying or blackening skin, a sign of tissue death Septic shock Rapid heart rate Low blood pressure A foul odor coming from the infection site Pus seeping form the site of injury Blisters [urologists.org]

  When there is extension onto the thigh or the abdominal wall, it is typically characterized by a bluish red blister; when this is debrided, the necrotic, underlying fascia is revealed. [e-ijd.org]

  Skin overlying the affected region may be normal, erythematous, edematous, cyanotic, bronzed, indurated, blistered, and/or frankly gangrenous. Skin appearance often underestimates the degree of underlying disease. [intechopen.com]

• Skin Lesion

  Bullae and ecchymotic skin lesions also point to the condition (and are not normally found with cellulitis). [ 2 ] A high index of suspicion is necessary and suspected cases should be referred immediately. Prompt surgical debridement is essential. [patient.info]

  Any unusual areas of pigmentation indicating new skin lesions or scarring from past injury or ulceration are observed and documented, with description given of the extent and nature of gangrene that is present. [medical-dictionary.thefreedictionary.com]

• Myalgia

  Case Presentation An otherwise healthy 29-year-old male presented to the emergency department (ED) after being evaluated at an outside urgent care clinic for two days of fever, vomiting, and diffuse myalgias. [hindawi.com]

• Somnolence

  However, when I saw him this morning he seemed somnolent and his white count had bumped to 20k. [buckeyesurgeon.com]

• Scrotal Pain

  The differential in the setting of acute scrotal pain includes: epididymo-orchitis testicular torsion testicular trauma scrotal cellulitis/abscess Promoted articles (advertising) [radiopaedia.org]

  In this case, pain and swelling involve both the scrotal contents and the groin area. [auanet.org]

  Upon further questioning, he also endorsed severe scrotal pain and swelling and frequent masturbation with soap as a lubricant. [hindawi.com]

  Unlike other conditions that cause acute scrotal pain, in Fournier’s gangrene the scrotal contents- the testes and epididymides- are normal, and no masses or other abnormal structures are present. [intechopen.com]

• Staphylococcus Aureus

  aureus, Bacteroides fragilis, Streptococcus species, and Clostridium species if Fournier's gangrene is suspected then urgent secondary care management is indicated - urgently start treatment (including antibiotics and surgical debridement as required [gpnotebook.com]

  The most prevalent organisms are Staphylococcus aureus, Staphylococci (Beta-haemolytic and anaerobic or microaerophilic), Escherichia coli, Bacteroides species, Pseudomonas, Proteus and Clostridia [4]. [academic.oup.com]

  It is caused by bacteria including group A streptococcus, Staphylococcus aureus and Clostridium perfringens. It may develop following trauma and invasive procedures. [fpnotebook.com]

The discussion includes a comparison of STSG with other treatment options. [ucdavis.pure.elsevier.com]

A three pronged treatment strategy consisting of antibiotic coverage for aerobes and anaerobes, general supportive measures and surgical debridement is usually applied [4]. [academic.oup.com]

Arch Ital Urol Androl 2016; 88(3):157-164. necrotizing fasciitis aetiology associations pathogenesis clinical features investigations treatment [gpnotebook.com]

The correct time for initiating surgery is important in the treatment of these patients 12. [rbcp.org.br]

Deciding factors to be considered include the gangrene being dry and not wet in nature, extent of the gangrene and also the overall prognosis of the patient. [anncaserep.com]

Despite the rarity of this disease, unfavorable prognosis related to this disease depends much on the timing of medical care. [karger.com]

It is considered a urological emergency with a poor prognosis due to its high mortality rate (ranging ~15-50% 3). [radiopaedia.org]

Outlook / Prognosis What is the prognosis (outlook) for Fournier’s gangrene? Fournier’s gangrene is life-threatening — as many as 50% of people with Fournier’s gangrene die because of it. [my.clevelandclinic.org]

Prognosis of Fournier's Gangrene Mortality of Fournier's gangrene is around 20%. Risk factors of increased mortality are diabetes mellitus, alcoholism and colorectal origin of Fournier's gangrene (often delayed diagnosis and extensive infection). [urology-textbook.com]

Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. [icd10coded.com]

However, we believe this is an oversight because the etiology and pathology of this rare entity is not completely unknown. [ijri.org]

The etiology, pathology, bacteriology and treatment of Fournier's gangrene are discussed. [unboundmedicine.com]

Tissue samples taken during the first two debridements revealed that the microbiological etiology of FG was polymicrobial. [jmedicalcasereports.biomedcentral.com]

Fournier stated that there were three characteristic findings of this syndrome: sudden onset in young and healthy males, rapid progression, and absence of a specific etiologic agent 1. The etiology of this disease is controversial. [rbcp.org.br]

Epidemiology Elderly adults (male and female), immunocompromised (particularly diabetes) or those with depressed mental status Sites Dartos and penile fascia are preferred sites Etiology 50 - 60% of infections have GI or GU source of infection Usually [pathologyoutlines.com]

"Fournier's gangrene: Population based epidemiology and outcomes". The Journal of Urology. 181 (5): 2120–6. doi : 10.1016/j.juro.2009.01.034. PMC 3042351. PMID 19286224. [en.wikipedia.org]

Ufimtseva MA, Malishevskaya NP, Syrneva TA: Clinical and epidemiological features of syphilis in the territories of the urals, siberia and the far east. Russian J Dermatovenereol 2009; 2: 68–73. Author Contacts Prof. M.A. [karger.com]

Epidemiological aspects of Fournier's gangrene at Kenyatta National Hospital, Nairobi. East Afr. Med. J. 75, 586–589 (1998). 9. Czymek, R. et al. New insights into the epidemiology and etiology of Fournier's gangrene: a review of 33 patients. [nature.com]

We postulate that the pathophysiology of this entity is related to arterial embolization of particulate matter into the microcirculation of the genitalia, which causes arterial thrombosis leading to localized gangrene. [ncbi.nlm.nih.gov]

This supports the pathophysiology of a general vasospastic effect on several end arteries. [anncaserep.com]

There are three possible pathophysiological mechanisms: local trauma, which would facilitate the entry of micro-organisms through injured skin; infection of the genitourinary tract, with extension to deep planes; and/or infection of the perineal or retroperitoneal [rbcp.org.br]

Symptoms and Pathophysiology The etiology of, and predisposing factors for, FG provide a favorable environment for infection. [uspharmacist.com]

Prevention How can I prevent Fournier’s gangrene? Experts have not yet found a way to prevent Fournier’s gangrene. However, there are a few ways to reduce your risk of Fournier’s gangrene, or at least catch it early. [my.clevelandclinic.org]

Keeping diabetes under control can help prevent the condition Controlling overweight and obese body conditions can help reduce the risk of this infection Avoiding alcohol: Avoiding the intake of alcohol reduces or prevents the risk of Fournier's Gangrene [dovemed.com]

Prevention. To prevent gangrene in an open wound, the wound should be kept as clean as possible. [medical-dictionary.thefreedictionary.com]

It is a preventable condition to some extent. We are reporting here a case of Fournier's gangrene in a 25-day-old male neonate who was treated aggressively with broad-spectrum antibiotics and early surgical debridement. [jcnonweb.com]