Fournier's Gangrene Research Paper

King Herod of Judea was suspected to have suffered from genital gangrene in association with diabetes mellitus.[4] In 1764, Baurienne originally described an idiopathic, rapidly progressive soft-tissue necrotizing process that led to gangrene of the male genitalia.

In 1883, the French venereologist Jean Alfred Fournier described a case series of 5 previously healthy young males who suffered from a rapidly progressive gangrene of the penis and scrotum , without apparent cause. He had used the term “fulminant gangrene of the penis ad scrotum”.[5] The 3 main points in his description included sudden onset disease in a previously healthy young man, rapid progression of the disease and absence of a definite cause.[6] Over the years, various authors

It is interesting to note that most of the factors associated with Fournier’s gangrene such as diabetes, colorectal and urogenital diseases, occur in later life.

Some have proposed poor socioeconomic conditions and alcoholism as contributory factors.[37]–[40][41] Regarding social class, Fournier’s gangrene occurs in affluent as well as poor communities as evidenced by many case reports from affluent areas of the USA and Europe.

 RELEVANT ANATOMY :

The complex anatomy of the male external genitalia helps in the initiation and progression of the disease process. It involves the superficial and deep fascial planes of the genitalia. When the organisms multiply, the infection spreads along the fascial planes, often sparing the deep muscular structures. This has implications at the time of initial debridement and later

Deep to the Camper’s fascia is the membranous layer called the Scarpa’s fascia. In the perineum, the Scarpa’s fascia blends into the Colles fascia, while it is continuous with the Dartos fascia of the penis and scrotum. The Colles fascia is also known as the superficial perineal fascia. The Scarpa’s and Camper’s fascia constitute the superficial fascia of the anterior abdominal wall. A potential space between the Scarpa’s fascia and the deep fascia of the anterior abdominal wall allows for the extension of perineal infection into the anterior abdominal wall. The Scarpa and Camper fascia coalesce and attach to the clavicles superiorly and limit further cephalad extension of any infection that may have stated in the perineum.The Colles fascia is attached to the pubic arch and the base of the perineal membrane and is continuous with the superficial Dartos fascia of the scrotum. This perineal membrane is also called the inferior fascia of the urogenital diaphragm and together with Colles fascia, it defines the superficial perineal