Open Access<p>Fournier Gangrene in the Emergency Department: Diagnostic Dilemmas, Treatments and Current Perspectives</p>
Author(s) -
Jonathan Auerbach,
Kasha Bornstein,
Mark Ramzy,
Jorge L. Cabrera,
Tim Montrief,
Brit Long
Publication year - 2020
Publication title -
open access emergency medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.408
H-Index - 14
ISSN - 1179-1500
DOI - 10.2147/oaem.s238699
Subject(s) - medicine , fasciitis , cellulitis , fournier gangrene , gangrene , intensive care medicine , abscess , disease , emergency department , infectious disease (medical specialty) , surgery , necrotising fasciitis , psychiatry
Fournier gangrene (FG) is a rare and life-threatening urosurgical emergency characterized most often by a polymicrobial infection of the perineal, genital, or perianal region. FG has an increased incidence in male patients, patients with alcoholism, and patients with immunocompromise including human immunodeficiency virus (HIV) and uncontrolled diabetes. FG often begins as a simple abscess or cellulitis with progression to necrotizing soft tissue infection (NSTI). Delays in diagnosis and treatment confer high mortality. Early recognition and high clinical suspicion are important in making a timely diagnosis, as early manifestations are often subtle. The most significant modifiable risk factor associated with NSTI mortality is delay to surgical intervention. Coordination of both inpatient medical and surgical teams to implement appropriate therapy is vital to successful outcomes. The emergency medicine clinician must be vigilant for this condition and be aware of risk factors, prognostic indicators, and proper treatment protocols to recognize FG early and initiate appropriate management. The objective of this review is to provide updated and relevant information regarding recognition, diagnosis, and management of FG for the emergency medicine provider.