Urogenital Tract Infection

Clinical Characteristics and Risk Factors of Fournier Gangrene: A 15-Years Multicenter Retrospective Study in Korea: Seung-Kwon Choi, Sin Woo Lee, Hyung-Lae Lee, Jeong Woo Lee, Jung Sik Huh, Yeonjoo Kim, Sangrak Bae, Tae-Hyoung Kim; Urogenit Tract Infect 2025;20(3):159-166. Published online December 31, 2025; DOI: https://doi.org/10.14777/uti.2550036018

Abstract PDF: Purpose
Fournier gangrene (FG) is a rare but life-threatening necrotizing infection requiring prompt recognition and intervention. This multicenter study aimed to investigate the clinical characteristics, treatment outcomes including mortality, and risk factors associated with death among patients with FG over the past 15 years in Korea. Materials and Methods: We retrospectively reviewed 84 patients diagnosed with FG between 2008 and 2022 across 7 hospitals. Demographics, comorbidities, laboratory findings, and clinical outcomes were analyzed. Mortality-related risk factors were assessed using univariate and multivariate logistic regression analysis.
Results
The mean age was 58.1±15.9 years, and 95.2% of patients were male. Diabetes mellitus (42.9%) and hypertension (36.9%) were the most prevalent comorbidities. Sepsis developed in 38.1% of patients, and the overall mortality rate was 14.3%. In univariate analysis, age ≥70 years, low body mass index, diabetes mellitus, low hemoglobin, low hematocrit, high respiratory rate, and Fournier gangrene severity index (FGSI) ≥9 were significantly associated with mortality. After data correction and multivariate adjustment, diabetes mellitus (odds ratio [OR], 39.61; 95% confidence interval [CI], 2.39–656.32; p=0.010) and respiratory rate (OR, 1.44; 95% CI, 1.09–1.91; p=0.011) were identified as independent predictors of mortality. FGSI≥9 demonstrated borderline association with mortality (p=0.08), indicating its potential clinical relevance.
Conclusions
In this multicenter Korean cohort, the mortality rate of FG remained substantial at 14.3%. Diabetes mellitus and elevated respiratory rate were independent predictors of mortality, while FGSI≥9 demonstrated a borderline yet clinically meaningful association, suggesting its role as a useful severity indicator in early risk stratification.

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Fournier’s Gangrene: A 10-Year Clinical Experience at a Tertiary Academic Medical Center: Woo Seop Seong, Byeong Jin Kang, A Reum Kim, Kyung Hwan Kim, Hong Koo Ha; Urogenit Tract Infect 2023;18(2):64-69. Published online August 31, 2023; DOI: https://doi.org/10.14777/uti.2023.18.2.64

Purpose: This retrospective study examined the factors influencing clinical outcomes and mortality in patients with Fournier's Gangrene (FG). The medical history, diagnostic procedures, treatment approaches, complications, and mortality factors associated with FG were analyzed.
Materials and Methods: This study retrospectively analyzed the medical records of 40 patients with FG treated over 10 years. The collected data included the patient demographics, comorbidities, vital signs, laboratory tests, Fournier’s Gangrene Severity Index (FGSI) scores, wound swab culture results, treatment approaches, and length of hospitalization.
Results: Among the patients with FG, diabetes mellitus and hypertension were the most common comorbidities. The hemodialysis dependence has been identified as a significant risk factor of mortality. In addition, septic shock and an FGSI >9 were associated with increased mortality. Escherichia coli was the most prevalent bacterium in wound swab cultures, and the presence of antibiotic-resistant bacteria was significantly higher in the non-survivors. Treatment involved broad-spectrum antibiotics, emergency surgical debridement, and subsequent adjustments based on culture results.
Conclusions: Early diagnosis and prompt initiation of treatment are essential for improving the outcomes of patients with FG. Hemodialysis dependency, septic shock, FGSI scores, and the presence of antibiotic-resistant bacteria are important factors associated with mortality in patients with FG. Further research will be needed to validate these findings and explore adjunctive therapies to enhance the patient outcomes and improve FG management.

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Prognostic factors and clinical outcomes in Fournier’s Gangrene: a retrospective study of 35 patients
Han Bee Hong, Jeong Woo Lee, Chan Hee Park
BMC Infectious Diseases.2024;[Epub] CrossRef

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Case of Fournier’s Gangrene in a Patient with Long-Term Indwelling Catheterization due to Urinary Incontinence after Open Radical Prostatectomy: Kyung Kgi Park, Sung Dae Kim, Young-Joo Kim, Jung-Sik Huh; Urogenit Tract Infect 2020;15(1):6-9. Published online April 30, 2020; DOI: https://doi.org/10.14777/uti.2020.15.1.6

Abstract PDF PubReader ePub: Fournier’s gangrene is a life-threatening disease that needs to be treated as soon as possible. An 82-year-old male, who exchanged a urethral catheter once a month for urinary incontinence management after open radical prostatectomy, presented with an acute onset of mental change and general weakness. After ten days’ hospitalization, the disease was diagnosed. The scrotal wall was opened, and the infectious tissue was exposed to the air and kept open with an aseptic dressing. After 45 days, his scrotal wound healed and returned to its typical appearance without scarring and wound disruption. He recovered fully from the infection. This paper reports a case of Fournier’s gangrene in a patient with long-term indwelling catheterization due to urinary incontinence after an open radical prostatectomy with a literature review.

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