Necrotizing soft-tissue infections of the perineum and genitalia. Etiology and early reconstruction.

Necrotizing fasciitis of the perineum and genitalia is a rare, rapidly progressive, often fatal infection whose unique bacterial involvement has frequently been ignored. From our experience with 14 patients, we recommend the following: early, aggressive surgical debridement and drainage to reduce morbidity and mortality; prompt institution of antimicrobial therapy directed at both aerobic and anaerobic organisms, with subsequent tailoring to the specific bacteria cultured, and early surgical reconstruction to avoid extensive scarring and cosmetic deformity and to allow earlier skin closure and a reduced hospital stay. In our series, long-term complications occurred in 3 patients, and 3 of the 14 died.