RSA - December 03, 2020 - By Alessandra Della Porta & Kasha Bornstein
Bottom Line Up Front:
Fournier gangrene (FG) is a necrotizing soft tissue infection (NSTI) associated with high mortality rates, particularly when it is not suspected early, or interventions are initiated late in the course. Diagnosis is clinical and challenged by overlap with more superficial skin infections (i.e. cellulitis) and the need for thorough examination of the genital region. Imaging and laboratory analysis are not able to consistently rule out FG. While risk calculators exist, they are also limited in their utility for ruling out severity of illness. This brief article discusses use of the monocyte-lymphocyte ratio, neutrophil-lymphocyte ratio, and platelet-lymphocyte ratio; recently innovated, simple, and effective biomarkers for prognosticating NSTIs...
Conclusion:
Positive outcomes in diagnosis and management of FG rely on rapid intervention as soon as it is suspected. A thorough physical exam, imaging, and laboratory studies can assist, but definitive diagnosis can only be made in the operating room. Newer validated scoring tools, such as the PLR, NLR, and MLR, may be some of the first results returned and offer faster risk stratification in FG, when time is of the essence."