Poll Results
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Consult Surgery for Fournier’s Gangrene
Explanation
There are few urologic emergencies that are more important to quickly recognize than Fournier’s gangrene. A necrotizing infection of the perineum, Fournier’s is usually caused by a polymicrobial infection. The condition is life-threatening with a mortality rate up to 22% despite aggressive therapy. 1
The infection has a predilection for diabetic, alcoholic, and immunocompromised patients. It commonly starts as a cellulitis of the perineum or perianal region accompanied by significant pain and swelling. Systemic signs are common, often “out of proportion” to the local extent of disease. Crepitus can develop due to gas forming organisms. It can quickly spread to involve the scrotum, penis, and abdominal wall before progressing to extensive necrosis, sepsis with multiple organ failure, and death. 2
Emergency physicians should immediately consult a surgeon and start broad spectrum antibiotics. 3
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Master Clinician Bedside Pearls
Dr Anton Helman, CCFP(EM)FCFP
Assistant Professor
University of Toronto
Founder & Host of EM Cases podcast
Author information
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