A 55-year-old diabetic man develops rapid-onset scrotal pain and swelling with foul-smelling discharge from the perineum, crepitus on palpation and toxicity. Which organism pair is most commonly implicated?
- A Treponema pallidum and Haemophilus ducreyi
- B Mycobacterium tuberculosis and Actinomyces israelii
- C Escherichia coli and anaerobes such as Bacteroides species ✓
- D Neisseria gonorrhoeae and Chlamydia trachomatis
Explanation
Fournier gangrene is necrotising fasciitis of the perineum, usually arising from an anogenital or urological source, and is typically polymicrobial: aerobic gram-negative bacilli such as Escherichia coli together with anaerobes such as Bacteroides, often plus streptococci. Diabetes mellitus is the commonest predisposing condition. Management is aggressive resuscitation, broad-spectrum antibiotics, radical debridement of all necrotic skin and fascia, and frequently repeated exploration. The sexually transmitted organisms listed produce ulcerative lesions rather than fulminant fascial necrosis.
Reference: Bailey and Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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