Form of necrotising fasciitis occurring about the male genitalia

Aetiology

• Most commonly arises from skin around the urethra or rectal region
• Predisposing factors:
  • Diabetes
  • Local trauma
  • Periurethral extravasion
  • Perianal infection
• Usually a mixture of aerobes/anaerobes

Clinical features

• Starts as cellulitis
  • Swollen, erythematous, tender
  • Marked pain, fever, systemic toxicity
• Swelling and crepitus of scrotum, dark purple areas
• Often marked toxicity out of proportion to the local findings

Investigations

• Plain x-ray/USS: may confirm gas in tissues if doubt (not usually needed)

Management

• Antibiotics and surgical debridement