Fournier's gangrene: a urologic emergency.

Fournier's gangrene, a form of necrotizing fasciitis, is an uncommon, fulminant, rapidly progressing subcutaneous infection of the scrotum and penis, and may occur in all age groups. Most cases involve a mixed synergistic infection of aerobic and anaerobic bacteria, and occur as a result of one of three mechanisms: local trauma, extension from a perianal, periurethral or ischiorectal infection. Fournier's gangrene is a urologic emergency that requires prompt recognition and aggressive hemodynamic stabilization, treatment with parenteral broad-spectrum antibiotics and surgical debridement. This disease is associated with a high mortality rate; a high index of suspicion is essential for early recognition whenever a patient presents with scrotal discomfort and swelling.