Fournier's gangrene can rarely occur in a neonate or young infant. It needs to be recognized early and treated aggressively as it can be fatal.
Risk factors:
(1) birth factors (out of hospital, breech, etc)
(2) poor hygiene
(3) immunodeficiency, including HIV
(4) native practices (in Third World countries)
(5) strangulated inguinal hernia
(6) trauma
(7) circumcision
(8) umbilical cord or umbilical care
Sites:
(1) omphalitis
(2) groin
(3) scrotum
(4) perineum
Clinical features:
(1) fever
(2) indurated and erythematous skin in affected area
(3) tachycardia
(4) hemodynamic instability
(5) subcutaneous emphysema
A delay in recognition or in parents bringing the patient in for care can be fatal.
Cultures may be negative while many are a mix of aerobic and anaerobic organisms. Proper specimen collection and culture is important, especially for anaerobic organisms.
While debridement is important, it is also important avoid extensive debridement.
