Extensive necrotizing soft tissue infection of the perineum.

Synergistic necrotizing fasciitis of the penis and scrotum was first described by Fournier, and remains a rare, but life-threatening disease. The reported mortality rates in different series range between 22 and 60%. We present a study of 20 patients treated over a 9 year period by early aggressive excision. Four of the treated patients (20%) died. A high index of suspicion, combined with early radical surgical intervention, is the key to effective treatment. Delayed diagnosis and treatment were the primary factors responsible for death.