Fournier’s gangrene is a type of necrotizing fasciitis (flesh-eating disease) that affects your scrotum, penis or perineum. Males are more likely to get this disease than females. There are ways you can reduce your risk of getting this life-threatening disease, and there are treatments. Go to the emergency department if you have symptoms.
Fournier’s gangrene is a rare, life-threatening bacterial infection of your scrotum, penis or perineum (the area between your genitals and rectum). It’s an infection that worsens quickly and requires emergency care. Go to the emergency department if your genitals or perineum are red, tender or swollen, and you have either a fever of at least 100.4 degrees Fahrenheit or you feel unwell in general.
Fournier is the name of the French physician who first identified this disease. Gangrene is where your tissues die because of a lack of blood flow or a bacterial infection. Fournier’s gangrene is a type of necrotizing fasciitis (flesh-eating disease). Necrotizing fasciitis destroys your soft tissues, including your:
Fournier’s gangrene affects the soft tissues of your scrotum, penis and perineum. In severe cases, the bacterial infection stretches to the thighs, stomach and chest, destroying those areas' muscles, nerves and arteries.
Fournier’s gangrene is life-threatening. Some studies concluded that 3% of people who get this type of necrotizing fasciitis will likely die. Other studies determined that the number is as high as 50%. But Fournier's gangrene is very rare. There are steps you can take to prevent it, and there are treatments available.
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Fournier’s gangrene is an emergency. Go to the emergency department if you have one or more symptoms of Fournier’s gangrene, including:
And one or both of the following symptoms, including:
Anyone at any age can get Fournier’s gangrene. Males are 10 times more likely to get Fournier’s gangrene than females. You’re at a higher risk if you have any of the following conditions, including:
You’re also at a higher risk of Fournier’s gangrene if:
Fournier’s gangrene is an emergency. Get an ambulance or take yourself to the emergency department if you observe symptoms.
When bacteria enter your perineum, scrotum or penis, they infect your subcutaneous tissue and muscle fascia. The subcutaneous tissue is the deepest layer of your skin. It contains connective tissues and fat cells. Fascia is a type of connective tissue. It covers every one of your organs, blood vessels, bones, nerve fibers and muscles and holds them in place.
There are arteries (blood vessels) within your subcutaneous tissue and muscle fascia. Your arteries transport nutrients and oxygen from your heart to your body's tissues. The pudenal artery that takes blood to your sex organs, to the skin of your perineum and to your scrotal skin. When bacteria enter the subcutaneous tissue and muscle fascia, they kill the branches of your pudendal artery. When the pudendal arterial tree is dead, that's when the bacteria spread further. They travel to the muscles and skin of your perineum, scrotum and penis and start destroying the arteries there, too. From there, they can go through the fascia to other areas of your body, such as your thighs, stomach and chest.
Please pay attention to the early symptoms of Fournier’s gangrene. By the time the bacteria affect the outer layer of your skin, they have already killed the arteries in your subcutaneous tissue and muscle fascia. Fournier’s gangrene gets worse (progresses) quickly. It’s so dangerous that just a few hours can mean the difference between life and death. But you can reduce your risk of getting it and, if you do get Fournier’s gangrene, there are treatments.
Fournier’s gangrene is rare. About 1.6 out of 100,000 males will get Fournier’s gangrene. It is unclear how many females and children get this disease.
If you take diabetes medications called sodium-glucose cotransporter-2 (SGLT2) inhibitors, you have a higher chance of getting Fournier’s gangrene. Examples of these inhibitors include:
Fournier’s gangrene is a rare disease. Very few people with diabetes should get this bacterial infection.
Bacteria (anaerobic bacteria or aerobic bacteria) sometimes cause Fournier's gangrene. The most common aerobic organisms include:
The most common anaerobic organisms include:
Bacteria can enter the genital and rectal areas of your body in several ways. A few examples include an:
Children sometimes get a bacterial infection from circumcision.
The first symptoms of Fournier’s gangrene you might notice include:
Additionally, if you have diabetes and notice your glucose is elevated despite taking your insulin as instructed, please contact your healthcare provider. This may be an early sign that something isn’t right.
Take the early symptoms of Fournier’s gangrene seriously. This infection moves forward very quickly, and you can get worse very suddenly. Don’t ignore the early signs.
The symptoms that go along with or follow the redness, tenderness and swelling of the genitals or perineum include:
Fournier’s gangrene can also affect your blood and heart. Examples of symptoms and conditions include:
There are some skin symptoms as well, including:
Some symptoms are in your urinary tract. Examples include:
The following conditions are associated with the late stages of Fournier’s gangrene:
Sudden pain in the genitals and perineum is usually the first symptom of Fournier’s gangrene. People describe the pain as tender, moderate or severe. The type of pain (dull, sharp, etc.) is unclear.
If you have Fournier's gangrene, the skin of your perineum, penis or scrotum will change color. Your skin might look reddish-purple, then turn to blue-gray and, finally, black when the tissues are dead.
Fournier’s gangrene is not a contagious disease. You won’t get this infection from anyone else, and they won’t get it from you.
Go to the emergency department if you’re experiencing the symptoms of Fournier’s gangrene.
Your healthcare provider will evaluate your symptoms and examine your skin. If there’s time, they’ll likely order some imaging tests, including:
Often, there is no time for tests. Immediate surgery might be necessary if the Fournier's gangrene has progressed to a dangerous point.
Part of your healthcare provider’s process to diagnose Fournier’s gangrene is to ask you questions. Those questions might include:
Have you had any recent trauma to the area?
Surgery is the number one treatment for Fournier’s gangrene. Sometimes it's necessary to skip the diagnosis process and go straight to debridement (the removal of damaged tissues from your body). There might be three or more operations. Ideally, your healthcare provider can remove enough tissue to keep the bacterial infection from spreading. Rarely, the entire penis and scrotum get surgically removed.
After the surgery, your healthcare provider will likely prescribe broad-spectrum antibiotics. If you also have sepsis, you’ll receive additional medications to decrease your risk of blood clots.
Next, you’ll have reconstructive surgery. Reconstructive surgery helps your perineum, scrotum or penis look like it did before the Fournier’s gangrene.
Finally, you might go through hyperbaric oxygen therapy. That is where you inhale pure oxygen in a pressurized room. The procedure helps in several ways, including:
Go to the emergency department if you have Fournier’s gangrene symptoms. It’s vital to get antibiotics and surgery.
You could be in the hospital for three to six weeks. How long it takes to recover after that is unclear. Talk to your healthcare providers about a timeline.
Experts have not yet found a way to prevent Fournier’s gangrene. However, there are a few ways to reduce your risk of Fournier’s gangrene, or at least catch it early. You can try to catch Fournier’s gangrene early by consistently checking your perineum, penis and scrotum for early symptoms, including:
You might reduce your risk of Fournier’s gangrene by taking the following precautions, including:
Fournier’s gangrene is life-threatening — as many as 50% of people with Fournier’s gangrene die because of it. But there are treatments, and there are ways to reduce your risk of Fournier's gangrene so that you're not part of that 50%.
Several factors affect the riskiness of your Fournier's gangrene, including:
Ask your healthcare providers for a detailed prognosis. It’s important to get treated right away to prevent serious outcomes.
There are many possible complications of Fournier’s gangrene. They include:
Don’t hesitate to see a healthcare provider at the emergency department if your genitals or perineum are red, tender or swollen, and you have a fever or just generally feel unwell.
A note from Cleveland Clinic
Looking at the symptoms and statistics of Fournier’s gangrene would frighten anyone. But remember — Fournier’s gangrene is a very rare type of necrotizing fasciitis. Fewer than two out of every 100,000 males should get this bacterial infection of the scrotum, penis or perineum.
Fournier's gangrene is a life-threatening disease, but there are ways you can reduce your risk. There are also treatments. Be especially careful if you have diabetes. Check the skin of your genitals and perineum regularly for any redness, tenderness or swelling. Also, look back at the "Prevention" section of this article for ways to reduce your risk of Fournier's gangrene.
Fournier’s gangrene is an emergency. It’s very important to get checked out right away if you have symptoms.
Last reviewed by a Cleveland Clinic medical professional on 10/18/2021.
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