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Fournier's Gangrene — SCE Infectious Diseases MCQ

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EasyInfection Prevention & ControlFournier's GangreneSCE Infectious Diseases

A 55-year-old man presents with Fournier's gangrene (necrotising fasciitis of the perineum and scrotum). He is septic and has crepitus on examination. What is the single most important immediate intervention?

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Correct answer: A — Emergency surgical debridement — this is a surgical emergency that cannot be managed with antibiotics alone

Fournier's gangrene is necrotising fasciitis of the perineum/genitalia. It is a life-threatening surgical emergency with mortality of 20–40%. Immediate radical surgical debridement is the single most critical intervention — every hour of delay increases mortality. Antibiotics (broad-spectrum: Piperacillin/Tazobactam or Meropenem plus Clindamycin for toxin suppression) are essential adjuncts but cannot substitute for surgery. Multiple returns to theatre for further debridement are often needed. Imaging must NOT delay surgery if the diagnosis is clinically apparent.

Reference: NICE NG141 2019 – Skin and soft tissue infections; WHO 2023 – Necrotising fasciitis