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Fournier Gangrene
Bryan R Foster, MD; Mitchell Tublin, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          TERMINOLOGY

          • Abbreviations

            • Fournier gangrene (FG)
            • Necrotizing soft tissue infection (NSTI)
          • Synonyms

            • NSTI of perineum
          • Definitions

            • Rapidly progressing, life-threatening, fulminant, necrotizing polymicrobial fasciitis of perineal, genital, and perianal regions

          IMAGING

          • General Features

            • Radiographic Findings

              • CT Findings

                • MR Findings

                  • Ultrasonographic Findings

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Staging, Grading, & Classification

                            • Microscopic Features

                              CLINICAL ISSUES

                              • Presentation

                                • Demographics

                                  • Natural History & Prognosis

                                    • Treatment

                                      DIAGNOSTIC CHECKLIST

                                      • Consider

                                        • Image Interpretation Pearls

                                          Selected References

                                          1. Montrief T et al: Fournier gangrene: a review for emergency clinicians. J Emerg Med. ePub, 2019
                                          2. Ballard DH et al: Preoperative CT findings and interobserver reliability of Fournier gangrene. AJR Am J Roentgenol. 211(5):1051-7, 2018
                                          3. Erichsen Andersson A et al: Signs, symptoms and diagnosis of necrotizing fasciitis experienced by survivors and family: a qualitative Nordic multi-center study. BMC Infect Dis. 18(1):429, 2018
                                          4. Bechar J et al: Laboratory risk indicator for necrotising fasciitis (LRINEC) score for the assessment of early necrotising fasciitis: a systematic review of the literature. Ann R Coll Surg Engl. 99(5):341-6, 2017
                                          5. Hagedorn JC et al: A contemporary update on Fournier's gangrene. Nat Rev Urol. 14(4):205-14, 2017
                                          6. Misiakos EP et al: Early diagnosis and surgical treatment for necrotizing fasciitis: a multicenter study. Front Surg. 4:5, 2017
                                          7. Weatherspoon K et al: Ultrasound Emergencies of the Male Pelvis. Semin Ultrasound CT MR. 38(4):327-344, 2017
                                          8. Yu M et al: Complicated Genitourinary Tract Infections and Mimics. Curr Probl Diagn Radiol. ePub, 2016
                                          9. Di Serafino M et al: A clinical case of Fournier's gangrene: imaging ultrasound. J Ultrasound. 17(4):303-6, 2014
                                          10. Mishra SP et al: Necrotizing Soft Tissue Infections: Surgeon's Prospective. Int J Inflam. 2013:609628, 2013
                                          11. Shyam DC et al: Fournier's gangrene. Surgeon. 11(4):222-32, 2013
                                          12. Sroczyński M et al: A complex approach to the treatment of Fournier's gangrene. Adv Clin Exp Med. 22(1):131-5, 2013
                                          13. Yoneda A et al: MRI can determine the adequate area for debridement in the case of Fournier's gangrene. Int Surg. 95(1):76-9, 2010
                                          14. Levenson RB et al: Fournier gangrene: role of imaging. Radiographics. 28(2):519-28, 2008
                                          15. Basoglu M et al: Management of Fournier's gangrene: review of 45 cases. Surg Today. 37(7):558-63, 2007
                                          16. Piedra T et al: Fournier's gangrene: a radiologic emergency. Abdom Imaging. 31(4):500-2, 2006
                                          Related Anatomy
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                                          Related Differential Diagnoses
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                                          References
                                          Tables

                                          Tables

                                          KEY FACTS

                                          • Terminology

                                            • Imaging

                                              • Top Differential Diagnoses

                                                • Clinical Issues

                                                  TERMINOLOGY

                                                  • Abbreviations

                                                    • Fournier gangrene (FG)
                                                    • Necrotizing soft tissue infection (NSTI)
                                                  • Synonyms

                                                    • NSTI of perineum
                                                  • Definitions

                                                    • Rapidly progressing, life-threatening, fulminant, necrotizing polymicrobial fasciitis of perineal, genital, and perianal regions

                                                  IMAGING

                                                  • General Features

                                                    • Radiographic Findings

                                                      • CT Findings

                                                        • MR Findings

                                                          • Ultrasonographic Findings

                                                            • Imaging Recommendations

                                                              DIFFERENTIAL DIAGNOSIS

                                                                PATHOLOGY

                                                                • General Features

                                                                  • Staging, Grading, & Classification

                                                                    • Microscopic Features

                                                                      CLINICAL ISSUES

                                                                      • Presentation

                                                                        • Demographics

                                                                          • Natural History & Prognosis

                                                                            • Treatment

                                                                              DIAGNOSTIC CHECKLIST

                                                                              • Consider

                                                                                • Image Interpretation Pearls

                                                                                  Selected References

                                                                                  1. Montrief T et al: Fournier gangrene: a review for emergency clinicians. J Emerg Med. ePub, 2019
                                                                                  2. Ballard DH et al: Preoperative CT findings and interobserver reliability of Fournier gangrene. AJR Am J Roentgenol. 211(5):1051-7, 2018
                                                                                  3. Erichsen Andersson A et al: Signs, symptoms and diagnosis of necrotizing fasciitis experienced by survivors and family: a qualitative Nordic multi-center study. BMC Infect Dis. 18(1):429, 2018
                                                                                  4. Bechar J et al: Laboratory risk indicator for necrotising fasciitis (LRINEC) score for the assessment of early necrotising fasciitis: a systematic review of the literature. Ann R Coll Surg Engl. 99(5):341-6, 2017
                                                                                  5. Hagedorn JC et al: A contemporary update on Fournier's gangrene. Nat Rev Urol. 14(4):205-14, 2017
                                                                                  6. Misiakos EP et al: Early diagnosis and surgical treatment for necrotizing fasciitis: a multicenter study. Front Surg. 4:5, 2017
                                                                                  7. Weatherspoon K et al: Ultrasound Emergencies of the Male Pelvis. Semin Ultrasound CT MR. 38(4):327-344, 2017
                                                                                  8. Yu M et al: Complicated Genitourinary Tract Infections and Mimics. Curr Probl Diagn Radiol. ePub, 2016
                                                                                  9. Di Serafino M et al: A clinical case of Fournier's gangrene: imaging ultrasound. J Ultrasound. 17(4):303-6, 2014
                                                                                  10. Mishra SP et al: Necrotizing Soft Tissue Infections: Surgeon's Prospective. Int J Inflam. 2013:609628, 2013
                                                                                  11. Shyam DC et al: Fournier's gangrene. Surgeon. 11(4):222-32, 2013
                                                                                  12. Sroczyński M et al: A complex approach to the treatment of Fournier's gangrene. Adv Clin Exp Med. 22(1):131-5, 2013
                                                                                  13. Yoneda A et al: MRI can determine the adequate area for debridement in the case of Fournier's gangrene. Int Surg. 95(1):76-9, 2010
                                                                                  14. Levenson RB et al: Fournier gangrene: role of imaging. Radiographics. 28(2):519-28, 2008
                                                                                  15. Basoglu M et al: Management of Fournier's gangrene: review of 45 cases. Surg Today. 37(7):558-63, 2007
                                                                                  16. Piedra T et al: Fournier's gangrene: a radiologic emergency. Abdom Imaging. 31(4):500-2, 2006