Emergency Central is a collection of disease, drug, and test information including 5-Minute Emergency Medicine Consult, Davis’s Drug, McGraw-Hill Medical’s Diagnosaurus®, Pocket Guide to Diagnostic Tests, and MEDLINE Journals created for emergency medicine professionals. Explore these free sample topics:
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- Inadequate hygiene leads to scrotal skin maceration and excoriation:
- Portal of entry for bacteria in tissue
- Once skin barrier is broken, polymicrobial flora spread along fascial planes of perineum.
- Colles fascia fuses with urogenital diaphragm, slowing propagation posteriorly and laterally.
- Anteriorly, Buck and Scarpa fascia are continuous, allowing rapid extension to anterior abdominal wall and laterally along fascia lata.
- Testes and urethra are usually spared.
- 3 anatomic origins account for most cases:
- Lower urinary tract (40%): Urethral strictures, indwelling catheters
- Penile or scrotal (30%): Condom catheters, hydradenitis, balanitis
- Anorectal (30%): Fistulas, perirectal infections, hemorrhoids
- Rarely, intra-abdominal sources such as perforating appendicitis, diverticulitis, or pancreatitis have produced Fournier gangrene by dependent contiguous spread.
- Infection by polymicrobial flora (mixed aerobic and anaerobic organisms)
- Mixed bacteria exert synergistic tissue-destructive effect.
- End arterial thrombosis in subcutaneous tissues produces anaerobic environment.
- Bacterial toxins and tissue necrosis factors may contribute to clinical presentation.
- Risk factors:
- Other immunocompromised states
- Morbid obesity
- Abdominal surgery