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Case report
Dangers of delayed diagnosis of perianal abscess and undrained perianal sepsis in Fournier’s gangrene: a case series
  1. Edgardo Solis1,2,
  2. Yi Liang3,
  3. Grahame Ctercteko4 and
  4. James Wei Tatt Toh4
  1. 1Department of Surgery, Westmead Hospital, Westmead, New South Wales, Australia
  2. 2Western Sydney Local Health District, Westmead, New South Wales, Australia
  3. 3Department of Surgery, Blacktown Hospital, Blacktown, New South Wales, Australia
  4. 4Department of Colorectal Surgery, Westmead Hospital, Westmead, New South Wales, Australia
  1. Correspondence to Dr Edgardo Solis; edgardosolis4{at}


Fournier’s gangrene (FG) is a rapidly progressing infective necrotising fasciitis of the perianal, perineal and genital region. It is characterised by its aggressive nature and high mortality rates of between 15% and 50%. While it has been commonly found to primarily develop from urological sources, there have been increasing reports of the role of colorectal sources as the underlying aetiology of FG. Presented is a case series of four FG presentations at a single institution during a 12-month period as a result of underlying untreated perianal disease highlighting its dangers in progressing to a deadly infection, advocating for early and aggressive surgical debridement, and the role of adjunct scoring systems, such as Laboratory Risk Indicator for Necrotising Fasciitis, in guiding clinical diagnosis.

  • general surgery
  • infectious diseases

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  • Contributors ES and YL were involved in the acquisition of data, analysis and interpretation of data, and writing of manuscript. JWTT and GC participated in the conception and design, interpretation of data and reviewing of manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer-reviewed.