The testicles, penis, and urethra are not commonly involved due to their autonomous blood supply.
- Severe fasciitis involving scrotum, perineum and anterior abdominal wall
- Bacteroides (most common anaerobe)
- Likely causes Group A streptococci
- Other streptococci
- Anaerobes including Clostridium sp.
- Diabetes mellitus (present in 60% of cases)
- Cirrhosis of the liver
- Systemic lupus erythematosus
- Crohn disease
- Human immunodeficiency virus (HIV) infection
- Morbid obesity.
- Tachycardia and hypotension, Cyanosis
- Severe genital pain, erythema, blistering, oedema
- Induration, and pruritus of the overlying skin
- Subcutaneous crepitus
- Wet gangrene with a faeculent odour due to anaerobic infection.
- Septic shock, Diabetic ketoacidosis
- Disseminated intravascular coagulation
- Acute kidney injury, Multiple organ failure
- Prolonged hospital admission.
- FBC ↑ WCC U&E: ↑ Creatinine ↑ CRP
- CT: defines the extent of disease and reveals fascial thickening, fat stranding, and soft tissue gas collection
- Always contact Consultant Microbiologist Always seek a surgical opinion
- Urgent medical/surgical condition treated with surgical debridement
- Initially Piperacillin/Tazobactam 4.5g tds IV
- For Penicillin allergy: clindamycin 600mg qds IV infusion plus Gentamicin once-daily IV