Abstract • Three children, aged 9 days, 3 weeks, and 9½ months, were treated for Fournier's syndrome. The portals of entry for a miscellaneous group of pathogens included a circumcision in the first, a circumcision and a diaper rash in the second, and a hot water burn in the third. The development of the condition after a circumcision is noteworthy because it is an extremely common surgical procedure. Medical and minor surgical treatment of the gangrenous areas during the period of rapid healing was successful. This approach contrasts with those researchers who recommend grafts. All three children survived, although one died three years later of complications from the original burn, and in another, one testicle could not be palpated after healing. (Am J Dis Child 132:1189-1191, 1978) References 1. Fournier JA: Gangrene foudroyante de la verge . Med Prat 4:589, 1883. 2. Fournier JA: Gangrene foudroyante de la verge . Sem Med 3:345, 1883. 3. Fournier JA: Etude clinique de la gangrene foudroyante de la verge . Sem Med 4:69, 1884. 4. Baurienne H: Sur une plaie contuse qui s'est terminee par le sphacele de le scrotum . J Med Chir Pharm 20:251-256, 1764. 5. Levinson A: Gangrene of the scrotum in infants and in children . Am J Dis Child 41:1123-1127, 1931. 6. Werner HJ, Falk M: Acute gangrene of the scrotum in an 8 year old . J Pediatr 65:133-136, 1964.Crossref 7. Campbell JC: Fournier's gangrene . Br J Urol 27:106-113, 1955.Crossref 8. Dunaif CB: Fournier's gangrene: Report of a case and review of the literature . Plast Reconstr Surg 33:84-92, 1964.Crossref 9. Gibson TE: Idiopathic gangrene of the scrotum . J Urol 23:125-129, 1930. 10. Gregory IL: Fournier's gangrene . Br J Urol 27:116-119, 1955.Crossref 11. Kilby JO: Gangrene of the scrotum and penis . Br J Surg 49:619-630, 1952.Crossref 12. Mair GB: Idiopathic gangrene of the scrotum . Lancet 1:446-466, 1945. 13. Randall A: Idiopathic gangrene of the scrotum . J Urol 4:219-235, 1920. 14. Talarico RD: Fournier's gangrene . Mod Treat 7:1049-1053, 1970. 15. Himal HS, McLean APH, Duff JH: Gas gangrene of the scrotum and perineum . Surg Gynecol Obstet 139:176-178, 1974. 16. Rudolph P, Soloway M, DePalma RG, et al: Fournier's syndrome: Synergistic gangrene of the scrotum . Am J Surg 129:591-596, 1975.Crossref 17. Thomas JF: Fournier's gangrene of the penis and the scrotum . J Urol 75:719-727, 1956. 18. Narducci F: Gangrene de genitali sequita da setticemia e morte in una bambina di 15 meso . Dermosifilografe 2:330-336, 1927. 19. Thorek P, Egel P: Reconstruction of the penis with split-thickness skin graft: A case of gangrene following circumcision for acute balanitis . Plast Reconstr Surg 4:469-472, 1949.Crossref 20. Brightmore T: Perianal gas-producing infection of nonclostridial origin . Br J Surg 59:109-116, 1972.Crossref 21. Berkow SG, Tolk NR: Ischiorectal abscess followed by gas gangrene: Gas gangrene following trauma: Report of two cases . JAMA 80:1689-1691, 1923.Crossref 22. Ross JC: Gangrene of the penis and scrotum as a surgical emergency . Br J Urol 7:158-161, 1935.Crossref 23. Burger R, Guthrie TH: Why circumcision . J Pediatr 54:363-364, 1974. 24. Rubenstein MM, Bason WM: Complications of circumcision done with a plastic bell clamp . Am J Dis Child 116:381-382, 1968. 25. Shulman J, Ben-Hur N, Newman Z: Surgical complications of a circumcision . Am J Dis Child 107:149-154, 1964. 26. Bolande RP: Ritualistic surgery, circumcision and tonsillectomy . N Engl J Med 280:541-596, 1969.Crossref 27. Hoosepian D: The pros and cons of routine circumcision . Calif Med 75:359-361, 1951. 28. Rosentsein JL: Wound diphtheria in the newborn infant following circumcision . J Pediatr 18:657-658, 1941.Crossref 29. Speert H: Circumcision of the newborn: An appraisal of its present status . Obstet Gynecol 2:164-171, 1953. 30. Patel H: The problem of routine circumcision . Can Med Assoc J 95:576-581, 1966. 31. Meleny FL: Differential diagnosis between certain types of infectious gangrene of the skin . Surg Gynecol Obstet 56:847-867, 1933. 32. Gray JA: Gangrene of the genitalia as seen in advanced periurethral extravasation with phlegmon . J Urol 8:740-745, 1960. 33. Mansfield OT: Spontaneous gangrene of the scrotum (Fournier's gangrene) . Br J Urol 33:247-277, 1946.
American Journal of Diseases of Children – American Medical Association
Published: Dec 1, 1978