Fournier's gangrene in an obese female in third trimester of pregnancy

Abstract

Fournier gangrene is a rapidly progressive necrotizing fasciitis of the perianal and genitourinary area. Although typically affects men, we present here a rare disease founding in a pregnant woman. An obese 36-year-old female patient in her third trimester of pregnancy presented with a history of perianal pain and swelling. She was subsequently diagnosed with Fournier gangrene and underwent emergency cesarean section with a surgical debridement. The key to successful outcomes in such a complicated presentation of Fournier gangrene includes a high index of suspicion, fluid resuscitation, rapid administration of broad-spectrum antibiotics, and an early interdisciplinary approach by multiple teams. This helps share decisions and balance the risk-benefit of the emergency caesarian section without delaying the surgical debridement.

Figure 1

Timeline summarizing the case presentation and the sequence of interventions.

Figure 2

Lateral view of pelvic x-ray showing the increased soft-tissue opacity with a variant size of subcutaneous gas bubbles.