{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T22:13:21Z","timestamp":1767910401694,"version":"3.49.0"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"826","license":[{"start":{"date-parts":[[1994,8,1]],"date-time":"1994-08-01T00:00:00Z","timestamp":775699200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1994,8,1]]},"abstract":"<jats:title>Summary<\/jats:title>\n               <jats:p>This paper reports a clinical study of 20 cases of gangrenous ulcers of the scrotum and\/or of the penis (Fournier's gangrene) and a review of previous publications. Even though found mostly in elderly male patients, the disease spares no age group and can involve the external genitalia in neonates and women as well. The disease is a necrotising fasciitis of infective origin and always has a portal of entry of the infecting organisms even though it may be so trivial as to be undetected. The commonest portals of entry of infection are periurethral sepsis, groin wound sepsis, anorectal sepsis, prostatic sepsis and trauma. The infecting organisms comprise both aerobic and anaerobic organisms such as Escherichia coli, Streptococcus pyogenes, Pseudomonas aeruginosa, Klebsiella pneumonia, Proteus mirabilis, enterococci, Bacteroides fragilis and anaerobic streptococcus. Fournier's gangrene is probably the same disease as necrotizing fasciitis occurring in other parts of the body, but modified by the peculiar anatomy of the genitoperineum.<\/jats:p>","DOI":"10.1136\/pgmj.70.826.568","type":"journal-article","created":{"date-parts":[[2008,12,29]],"date-time":"2008-12-29T21:25:21Z","timestamp":1230585921000},"page":"568-571","source":"Crossref","is-referenced-by-count":44,"title":["The features and aetiology of Fournier's gangrene"],"prefix":"10.1093","volume":"70","author":[{"given":"S E E","family":"Efem","sequence":"first","affiliation":[{"name":"University Teaching Hospital , Calabar, Nigeria"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[1994,8,1]]},"reference":[{"issue":"4","key":"ref_1","first-page":"589","article-title":"Gangrene foudroyante de loa verge","volume":"1883","author":"Fournier, J.A.","unstructured":"Fournier, J.A. Gangrene foudroyante de loa verge. Med Pract Paris 1883, 4: 589-597.","journal-title":"Med Pract Paris"},{"issue":"4","key":"ref_2","first-page":"69","article-title":"Etude clinique de la gangrene foudroyante de la verge","volume":"1884","author":"Fournier, J.A.","unstructured":"Fournier, J.A. Etude clinique de la gangrene foudroyante de la verge. Semaine Med 1884, 4: 69-74.","journal-title":"Semaine Med"},{"issue":"1","key":"ref_3","first-page":"464","article-title":"Idiopathic gangrene of the scrotum","volume":"1945","author":"Mair, G.B.","unstructured":"Mair, G.B. Idiopathic gangrene of the scrotum. Lancet 1945, 1: 464.","journal-title":"Lancet"},{"issue":"25","key":"ref_4","first-page":"60","article-title":"Idiopathic gangrene of the scrotum in West Africans","volume":"1953","author":"Thomas, H.O.","unstructured":"Thomas, H.O. Idiopathic gangrene of the scrotum in West Africans. Br J Surg 1953, 25: 60-62.","journal-title":"Br J Surg"},{"issue":"75","key":"ref_5","first-page":"719","article-title":"Fournier's gangrene of the penis and scrotum","volume":"1956","author":"Thomas, J.F.","unstructured":"Thomas, J.F. Fournier's gangrene of the penis and scrotum. J Urol 1956, 75: 719-727.","journal-title":"J Urol"},{"issue":"61","key":"ref_6","first-page":"451","volume":"1988","author":"Fahal, A.H.; Hassan, M.A.Fournier's gangrene in Khartoum; Sudan","unstructured":"Fahal, A.H. & Hassan, M.A. Fournier's gangrene in Khartoum, Sudan. Br J Urol 1988, 61: 451-454.","journal-title":"Br J Urol"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1111\/j.1464-410X.1989.tb06020.x","article-title":"Treatment and complications of Fournier's gangrene","volume":"64","author":"Wolach, M.D.; MacDermott, J.P.; Stone, A.R.; de Vere White, R.W.","year":"1989","unstructured":"Wolach, M.D., MacDermott, J.P., Stone, A.R. & de Vere White, R.W. Treatment and complications of Fournier's gangrene. Br J Urol 1989, 64: 310-314.","journal-title":"Br J Urol"},{"issue":"381 -383","key":"ref_8","article-title":"Flemon perineal necrotizante (Gangrene de Fournier). Necrotising perineal phlegmon (Fournier's gangrene)","volume":"13","author":"Octavio-Castillo, C.; Carlos-Martinez, S.","year":"1989","unstructured":"Octavio-Castillo, C. & Carlos-Martinez, S. Flemon perineal necrotizante (Gangrene de Fournier). Necrotising perineal phlegmon (Fournier's gangrene). Acta Urol Esp 1989, 13: 381 -383.","journal-title":"Acta Urol Esp"},{"key":"ref_9","first-page":"277","article-title":"Management of perineal necrotising fasciitis (Fournier's gangrene)","volume":"78","author":"Hirn, M.; Niinikoski, J.","year":"1989","unstructured":"Hirn, M. & Niinikoski, J. Management of perineal necrotising fasciitis (Fournier's gangrene). Ann Chir Gynaecol 1989, 78: 277-281."},{"issue":"66","key":"ref_10","first-page":"434","article-title":"Delayed recognition of an intersphincteric abscess as a cause of Fournier's scrotal gangrene","volume":"1984","author":"Jamieson, N.V.; Everett, W.G.; Bullock, K.N.","unstructured":"Jamieson, N.V., Everett, W.G. & Bullock, K.N. Delayed recognition of an intersphincteric abscess as a cause of Fournier's scrotal gangrene. Ann Roy Coll Surg Engi 1984,66: 434-435.","journal-title":"Ann Roy Coll Surg Engi"},{"key":"ref_11","first-page":"1097","article-title":"A case of Fournier's gangrene: was it triggered by prostatic massage?","volume":"36","author":"Sengoku, A.; Yamashita, M.; Umezu, K.","year":"1990","unstructured":"Sengoku, A., Yamashita, M. & Umezu, K. A case of Fournier's gangrene: was it triggered by prostatic massage? Hinyokika Kiyo 1990, 36: 1097-1 100 (in Japanese).","journal-title":"Hinyokika Kiyo"},{"key":"ref_12","first-page":"204","article-title":"Gangrene van Fournier (Fournier's gangrene)","volume":"90","author":"Leenen, L.P.; Van de Werken, C.","year":"1990","unstructured":"Leenen, L.P. & Van de Werken, C. Gangrene van Fournier (Fournier's gangrene). Acta Chir Belg 1990, 90: 204-206.","journal-title":"Acta Chir Belg"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"984","DOI":"10.1016\/S0022-5347(17)39641-6","article-title":"Pyoderma gangrenosum presenting as Fournier's gangrene","volume":"144","author":"Baskin, I.S.; Doxon, C.; Stoller, M.L.; Carroll, P.R.","year":"1990","unstructured":"Baskin, I.S., Doxon, C., Stoller, M.L. & Carroll, P.R. Pyoderma gangrenosum presenting as Fournier's gangrene. J Urol 1990, 144: 984-986.","journal-title":"J Urol"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1001\/archsurg.1983.01390010028007","article-title":"Fournier's gangrene of the scrotum. A poorly defined syndrome or a misnomer?","volume":"118","author":"Lamb, R.C.; Juler, G.L.","year":"1983","unstructured":"Lamb, R.C. & Juler, G.L. Fournier's gangrene of the scrotum. A poorly defined syndrome or a misnomer? Arch Surg 1983, 118: 38-40.","journal-title":"Arch Surg"},{"issue":"84","key":"ref_15","first-page":"740","article-title":"Gangrene of the genitalia in advanced periurethral extravasation with phlegmon","volume":"1960","author":"Gray, J.A.","unstructured":"Gray, J.A. Gangrene of the genitalia in advanced periurethral extravasation with phlegmon. J Urol 1960, 84: 740-745.","journal-title":"J Urol"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1111\/j.1464-410X.1983.tb07087.x","article-title":"Fournier's gangrene: necrotising fascitis of the male genitalia","volume":"55","author":"Balhamann, J.C.M.; Fourie, J.V.H.; Arndt, T.C.M.","year":"1983","unstructured":"Balhamann, J.C.M., Fourie, J.V.H. & Arndt, T.C.M. Fournier's gangrene: necrotising fascitis of the male genitalia. Br J Urol, 1983, 55: 85-88.","journal-title":"Br J Urol"},{"key":"ref_17","first-page":"509","article-title":"Fournier's gangrene and urethral problems","volume":"56","author":"Walker, L.; Cassidy, M.T.; Hutchinson, A.G.; Abel, B.J.; Lewis, H.J.E.","year":"1984","unstructured":"Walker, L., Cassidy, M.T., Hutchinson, A.G., Abel, B.J. & Lewis, H.J.E. Fournier's gangrene and urethral problems. Br J Urol 1984, 56: 509-51 1.","journal-title":"Br J Urol"},{"key":"ref_18","first-page":"423","article-title":"Synchronous caverno-spongious thrombosis and Fournier's gangrene","volume":"43","author":"Campos, J.A.; Martos, J.A.; Gutierez del Pozo, R.; Carretero, P.","year":"1990","unstructured":"Campos, J.A., Martos, J.A., Gutierez del Pozo, R. & Carretero, P. Synchronous caverno-spongious thrombosis and Fournier's gangrene. Arch Esp Urol 1990, 43: 423-426.","journal-title":"Arch Esp Urol"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"272","DOI":"10.1136\/bmj.1.5743.272","article-title":"Scrotal gangrene after male sterilization","volume":"1","author":"Pryor, J.R.; Bella, J.Y.; Packham, D.A.","year":"1971","unstructured":"Pryor, J.R., Bella, J.Y. & Packham, D.A. Scrotal gangrene after male sterilization. Br Med J 1971, 1: 272.","journal-title":"Br Med J"},{"key":"ref_20","first-page":"182","article-title":"Fournier's gangrene of the scrotum following traumatic urethral catheterization","volume":"32","author":"Conn, I.G.; Lewis, H.J.E.","year":"1987","unstructured":"Conn, I.G. & Lewis, H.J.E. Fournier's gangrene of the scrotum following traumatic urethral catheterization. J Roy Coll Surg 1987, 32: 182-184.","journal-title":"J Roy Coll Surg"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"823","DOI":"10.1016\/S0022-5347(17)38904-8","article-title":"Foumier's gangrene in hypersensitivity vasculitis","volume":"142","author":"Sohn, M.; Kistler, D.; Kindler, J.; Lutzeyer, W.","year":"1989","unstructured":"Sohn, M., Kistler, D., Kindler, J. & Lutzeyer, W. Foumier's gangrene in hypersensitivity vasculitis. J Urol 1989, 142: 823-825.","journal-title":"J Urol"},{"key":"ref_22","first-page":"553","article-title":"Fournier's gangrene","volume-title":"Pathology in the Tropics","author":"Edington, G.M.; Giles, H.M.","year":"1976","unstructured":"Edington, G.M. & Giles, H.M. Fournier's gangrene. In: Edington, G.M. & Giles, H.M. (eds) Pathology in the Tropics, 2nd edn. Edward Arnold, London, 1976, pp. 553-555.","edition":"2nd edn."},{"issue":"7","key":"ref_23","first-page":"181","article-title":"Strangulated Richter's hernier presenting as Fournier's gangrene","volume":"1985","author":"Efem, S.E.E.","unstructured":"Efem, S.E.E. Strangulated Richter's hernier presenting as Fournier's gangrene. Postgrad Doctor Africa 1985, 7: 181-182.","journal-title":"Postgrad Doctor Africa"},{"key":"ref_24","first-page":"846","article-title":"Fasciite necrosante synergistique du perinee gangrene de Fournier","volume":"116","author":"Lok, C.; Trabettoni, M.; Labeille, B.","year":"1989","unstructured":"Lok, C., Trabettoni, M., Labeille, B. et al. Fasciite necrosante synergistique du perinee gangrene de Fournier. Ann Dermatol Venerol 1989, 116: 846-847."},{"key":"ref_25","first-page":"2768","article-title":"Kirurgisk behandling ved nekrostiserende fascitis (surgical treatment of necrotising fascitis)","volume":"109","author":"Aasen, A.O.; Rund, T.H.; Haffne, J.; Raeder, M.","year":"1989","unstructured":"Aasen, A.O., Rund, T.H., Haffne, J., Raeder, M. et al. Kirurgisk behandling ved nekrostiserende fascitis (surgical treatment of necrotising fascitis). 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Arch Surg 1924, 9: 317-364.","journal-title":"Arch Surg"},{"issue":"38","key":"ref_29","first-page":"579","article-title":"A progressive enlarging ulcer of abdominal wall involving the skin and fat, following drainage of abdominal abscess apparently ofappendiceal origin","volume":"1924","author":"Cullen, T.S.","unstructured":"Cullen, T.S. A progressive enlarging ulcer of abdominal wall involving the skin and fat, following drainage of abdominal abscess apparently ofappendiceal origin. Surg Gynecol Obstet 1924, 38: 579-582.","journal-title":"Surg Gynecol Obstet"},{"issue":"18","key":"ref_30","first-page":"416","volume":"1953","author":"Wilson, B.Necrotisingfascitis","unstructured":"Wilson, B. Necrotisingfascitis. Am JSurg 1953,18:416-431.","journal-title":"Am JSurg"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1016\/0090-4295(90)80088-5","article-title":"Fournier's gangrene in children","volume":"35","author":"Adams, Jr, J.R.; Mata, J.A.; Venable, D.D.; Culkin, D.J.; Bocchini, Jr, J.A.","year":"1990","unstructured":"Adams, J.R., Jr, Mata, J.A., Venable, D.D., Culkin, D.J. & Bocchini, J.A., Jr. Fournier's gangrene in children. Urology 1990, 35: 439-441.","journal-title":"Urology"},{"key":"ref_32","first-page":"48","article-title":"Foumier's gangrene in a newborn","volume":"47","author":"Silva-Villasenor, J.A.; Velazquez Macias, R.F.; Suarez, J.J.; Galvan Mantano, A.; Quintos Aranda, C.","year":"1990","unstructured":"Silva-Villasenor, J.A., Velazquez Macias, R.F., Suarez, J.J., Galvan Mantano, A. & Quintos Aranda, C. Foumier's gangrene in a newborn. Bol Med Hosp Infant Mex 1990, 47: 48-50.","journal-title":"Bol Med Hosp Infant Mex"},{"key":"ref_33","first-page":"115","article-title":"Gangrene de Fournier: etude analytique de six cas (Fournier's gangrene: analytical study of 6 cases)","volume":"127","author":"Bugra, D.; Bozfakioglu, Y.; Buyukuncu, Y.; Bulut, T.","year":"1990","unstructured":"Bugra, D., Bozfakioglu, Y., Buyukuncu, Y. & Bulut, T. Gangrene de Fournier: etude analytique de six cas (Fournier's gangrene: analytical study of 6 cases). J Chir Paris 1990, 127: 115-116.","journal-title":"J Chir Paris"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"838","DOI":"10.1002\/bjs.1800780722","volume":"78","author":"Asfar, S.K.; Baraka, A.; Juma, T.; Ma'Rafie, Q.; Aladeen, T.; Al Sayer, H.","year":"1991","unstructured":"Asfar, S.K, Baraka, A., Juma, T., Ma'Rafie, Q., Aladeen, T. & Al Sayer, H. Necrotising fascitis. Br J Surg 1991, 78: 838-840.","journal-title":"Necrotising fascitis. 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