A Case of Fournier's Gangrene

Sara E. Champion, MSN, RN, FNP-C, CUNP

Disclosures

Urol Nurs. 2007;27(4):296-299. 

In This Article

Introduction and Etiology

Necrotizing fasciitis is a rare, life-threatening illness. Fournier's gangrene is specific to necrotizing fasciitis of the genital or perineal area. Its name comes from the French venereologist, Dr. Jean Alfred Fournier (MedicineNet, Inc., 2007), who is credited with first identifying it in 1883. Fournier's is observed in people of all ages, with the mean age being 50, and is more commonly found in males than females with a 10:1 ratio (Thomsen & Legome, 2005; Yalamarthi & Dayal, 2006). The occurrence within the general population is believed to be 0.4/100,000 adults and 0.08/ 100,000 children (Trent & Kirsner, 2002). The mortality rate of 4% to 75% is reported in the literature. However, rates between 25% and 35% are most commonly reported and increase with extremes of age, delay in diagnosis or treatment, and presence of preexisting medical conditions (Thomsen & Legome, 2005). Various bacteria have been identified with necrotizing fasciitis (see Table 1 ). But, the mechanism of tissue destruction is usually the same, and involves both aerobic and anaerobic microbes working synergistically. Aided by the release of bacterial toxins and enzymes, including collagenases and hya luronidases, these organisms cause the formation of thrombi within the blood vessels leading to eventual tissue death. Anae robic bacteria fueled via the byproducts of aerobic bacteria accelerate the necrosis along fascial planes as rapidly as 2 to 3 cm/hour (Neary, 2005). The release of gaseous waste products by anaerobic bacteria assists in diagnosis of the disease.

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