INFECTION AND INFLAMMATION OF THE PENIS AND URETHR

INFECTION AND INFLAMMATION OF THE PENIS AND URETHRA Fournier’s gangrene

This is progressive infection of the genitalia and perineum ( Figure 85.25 ). It is usually caused by mixed bacterial flora ( Escherichia coli , Bacteroides spp., Streptococcus pyogenes , Staphy - lococcus aureus ). It may be associated with diabetes, cancer, malnutrition, recent urogenital or colorectal instrumentation or trauma. The hallmark is rapid progression from symptoms and signs of cellulitis. There is erythema, swelling, pain and blister formation with ultimately foul-smelling necrotic lesions. It is a surgical emergency . Progression from genitalia to perineum to risk of bacterial septicaemia. It will lead to death if untreated. Treatment involves a combination of broad-spectrum anti biotics and extensive surgical debridement.