Fournier gangrene physical examination

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Steven C. Campbell, M.D., Ph.D.; Associate Editor(s)-in-Chief: Yamuna Kondapally, M.B.B.S[1]; Jesus Rosario Hernandez, M.D. [2]

Overview

In the physical examination of Fournier gangrene, the patients with Fournier gangrene usually appear to be ill. *Tachycardia and hypotension are mostly present and the skin may show evidence of trauma, surgery, insect or human bites, or injection sites. Ppalpation of genitalia and perineum, and digital rectal examination may reveal induration, eryhthema, swelling, erythema with ill defined margins, blistering/bullae, skin discoloration, foul discharge (greyish or brown discharge), and fluctuance

Physical examination

The physical examination of Fournier gangrene include:

Appearance of the Patient

The patients with Fournier gangrene usually appear to be ill.

Vitals

• Fever (is often absent)
• Tachycardia
• Hypotension
• Tachypnea

Skin

• Jaundice
• Evidence of trauma, surgery, insect or human bites, or injection sites

Local examination

Local examination of patient under local anesthesia includes palpation of genitalia and perineum, and digital rectal examination.

• Induration
• Warmth
• Tenderness beyond margins of erythema
• Swelling
• Erythema with ill defined margins
• Blistering/bullae
• Skin discoloration
• Foul discharge (greyish or brown discharge)
• Fluctuance
• Crepitus
• Skin sloughing or necrosis
• Absence of lymphangitis or lymphadenopathy (lymphangitis is rarely seen in Fournier gangrene)
• Sensory and motor deficits (e.g. localized anesthesia)