Fournier's gangrene in neonates and infants

Background: Fournier's gangrene is uncommon in childhood and little is known about the disease in this age group. Method: A retrospective review was carried out of neonates and infants treated for Fournier's gangrene over a period of 16 years. Results: Twelve neonates and infants aged 5 days - 3 months (median 3 weeks) were treated in our hospital. The precipitating cause was omphalitis in 7 babies, strangulated inguinal hernia in 2 and in 3 babies there was no identifiable cause. Gram-negative bacteria were cultured in 3 patients, but in most the culture was sterile. Treatment consisted of debridement of devitalised tissue and administration of broad-spectrum antibiotics. Primary closure was achieved in 1 baby and secondary closure in 2 others. In 7 babies the wound contracted rapidly and healed. There was no mortality. Conclusion: Fournier's gangrene in neonates and infants in our environment is largely preventable. Early debridement and appropriate antibiotics give good results.