Fournier's gangrene.

Fournier's disease--gangrene of the penis and scrotum--is an uncommon condition. During the past 6 years, five patients, whose cases are described, were admitted to Toronto General Hospital with this diagnosis. Four had preceding trauma (ischiorectal abscess, puncture wound, surgery) and four had pre-existing debilitating problems (diabetes, rectal carcinoma, acute lymphocytic leukemia, alcoholic cirrhosis). Appropriate treatment must include urgent radical surgery to remove all necrotic tissue, and combination antibiotic therapy directed against the likely organisms, which are aerobic gram-negative rods, gram-positive cocci and anaerobes. Clindamycin in combination with tobramycin or gentamicin proved to be effective in this series.