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Fournier gangrene is a form of necrotising fasciitis (gangrene) that can affect the vulva and/or perineum in women. It most often occurs in men, however, with anyone suffering diabetes, alcoholism, kidney problems, steroid use or immune system deficiencies most at risk.1,2
A 2009 study stated that 39 out of 1,680 cases of Fournier gangrene were found in women, in particular older women between the ages of 50 and 100.
Some researchers believe that Fournier gangrene is a polymicrobial skin condition. This type of gangrene can occur after episiotomy or a Bartholin’s abscess.3
Symptoms of Fournier gangrene in women4
- Swelling
- Pain in the perineal or perianal area
- Fever
- Weakness
- Foul odour
- Pus
- Skin turns black
- Occurs quickly
Causes of Fournier gangrene Bacteria are the cause of Fournier gangrene, with both aerobic and anaerobic bacteria found guilty. In one study, the type of bacteria found included:
- Escherichia coli
- Klebsiella pneumoniae
- Enterococcus
- Morganella
- Pseudomonas
- Streptococcus
- Staphylococcus
- Proteus
- Bacteroides spp.
- Peptostreptococcus
- Prevotella
- Clostridium difficile
Treatment of Fournier gangrene
The typical treatment of Fournier gangrene is antibiotics intravenously, with surgical removal of dead tissue. Hyperbaric oxygen chambers have been used to increase oxygen in damaged tissue while also killing anaerobic bacteria.5,6
- Hong KS, Yi HJ, Lee R, Kim KH, Chung SS. Prognostic factors and treatment outcomes for patients with Fournier's gangrene: a retrospective study. International Wound Journal. 2017;14(6):1352–1358.
- Aşcı R, Sarıkaya &, Büyükalpelli R, Yılmaz AF, Yıldız S. Fournier’s Gangrene: Risk Assessment and Enzymatic Debridement with Lyophilized Collagenase Application. European Urology. 1998;34(5):411–418.
- Kuzaka B, Wróblewska MM, Borkowski T, et al. Fournier’s Gangrene: Clinical Presentation of 13 Cases. Medical Science Monitor. 2018;24:548–555.
- Zhang N, Yu X, Zhang K, Liu T. A retrospective case series of Fournier’s gangrene: necrotizing fasciitis in perineum and perianal region. BMC Surgery. 2020;20(1).
- Lewis GD, Majeed M, Olang CA, et al. Fournier’s Gangrene Diagnosis and Treatment: A Systematic Review. Cureus. 2021.
- Raizandha MA, Hidayatullah F, Kloping YP, Rahman IA, Djatisoesanto W, Rizaldi F. The role of hyperbaric oxygen therapy in Fournier’s Gangrene: A systematic review and meta-analysis of observational studies. International braz j urol. 2022;48(5):771–781.
