Abstract
Introduction: Fournier’s gangrene is a rare, rapidly progressive, necrotizing fasciitis of the external genitalia and
perineum. Case series have shown a mortality rate of 20% to 40% with an incidence of as high as 88% in some
reports. In this study we aimed to share our experience in the management of Fournier’s gangrene and to identify
risk factors that affect mortality.
Methods: The medical records of 50 patients with Fournier’s gangrene who presented at the University Hospital
Hassan II of Fez from January 2003 to December 2009 were reviewed retrospectively to analyze the outcome and
identify the risk factors and prognostic indicators of mortality.
Results: Ten males and five females were enrolled in the study. The mean age was 54 years (range 23–81). The
most common predisposing factor was diabetes mellitus (34%). E. coli was the most frequent bacterial organisms
cultured. All patients were treated with a common approach of resuscitation, broad-spectrum antibiotics, and wide
surgical excision. The mortality rate was 24%. The advanced age, renal failure on admission, extension of infection
to the abdominal wall, occurrence of septic shock and need for postoperative mechanical ventilation are the main
prognostic factors of mortality. In multivariate analysis, none of these variables is an independent predictor of
mortality.
Conclusions: Fournier’s gangrene is still a very severe disease with high mortality rates. Early recognition of
infection associated with invasive and aggressive treatment is essential for attempting to reduce these prognostic
indices