A CASE STUDY AND CLINICAL LITERATURE REVIEW OF FOURNIER’S GANGRENE, DEMONSTRATING RESOLUTION WITH ANTIBIOTIC THERAPY AND IN THE ABSENCE OF SURGICAL OR ANY OTHER INTERVENTION

Dr. Neville Aquilina* MD, MRCP (UK), MRCP Geriatric Medicine (UK) and Dr. Vincent Bugeja MD, MRCP(UK), MRCP Geriatric Medicine (UK), PGDipGer

ABSTRACT

This case report describes a lesser common condition, namely Fournier's gangrene, involving a rapidly advancing, necrotising infection of deep tissues, starting from the perineal area with spread along fascial planes. The aggressive nature of this condition renders early diagnosis and treatment imperative. Our case is unusual in that we achieved good results utilising intravenous antibiotics alone, guided appropriately via culture and sensitivities. This contrasts with the general literature that advocates for concomitant surgical debridement and/or other measures as outlined in the literature review in order to optimise outcome. Our view is that in frail, elderly or 'high risk' patients the surgical and other wound management interventions are likely to increase mortality and that it may be possible to achieve success in such circumstances utilising antibiotics alone, particularly if the condition is recognised early.

Keywords: Necrotising; Polymicrobial; Antibiotics; Frail.