Question:medium
Which statement is true among all regarding the condition shown?
A. Associated with mixed aerobic and anaerobic infection
B. Orchidectomy should be done
C. Anti-gas gangrene serum should always be used
D. Urinary diversion done
Which statement is true among all regarding the condition shown?
A. Associated with mixed aerobic and anaerobic infection
B. Orchidectomy should be done
C. Anti-gas gangrene serum should always be used
D. Urinary diversion done
A. Associated with mixed aerobic and anaerobic infection
B. Orchidectomy should be done
C. Anti-gas gangrene serum should always be used
D. Urinary diversion done
Show Hint
Think about the microbiology of synergistic necrotizing fasciitis of the perineum.
Updated On: Jun 23, 2026
- Associated with mixed aerobic and anaerobic infection
- Orchidectomy should be done
- Anti-gas gangrene serum should always be used
- Urinary diversion done
Show Solution
The Correct Option is A
Solution and Explanation
Approach: Fournier's gangrene (perineal necrotizing fasciitis) is a rapidly progressive, life-threatening synergistic infection of the perineum and external genitalia.
Microbiology: The hallmark of Fournier's gangrene is a polymicrobial synergistic infection -- a combination of aerobic bacteria (e.g., $E.$ $coli$, $Klebsiella$, $Proteus$) and anaerobic bacteria (e.g., $Bacteroides$, $Clostridium$, $Peptostreptococcus$). The aerobes consume oxygen, creating a low-oxygen microenvironment that favours anaerobic proliferation, while anaerobes produce toxins (e.g., collagenase, hyaluronidase) that facilitate further spread.
Why the testes are spared: The testes receive blood via the testicular arteries (branches of the abdominal aorta) in addition to cremasteric vessels. These vessels are outside the fascial planes involved in Fournier's gangrene, so the testes retain viability -- hence orchidectomy is NOT done.
Management: Emergency wide surgical debridement + broad-spectrum antibiotics (covering aerobes and anaerobes) + ICU support. Anti-gas gangrene serum is NOT routinely indicated. Urinary diversion is only needed if the urethra/bladder is involved -- not universally required.
\[\boxed{\text{Answer: A -- Mixed aerobic and anaerobic (synergistic) infection}}\]
Microbiology: The hallmark of Fournier's gangrene is a polymicrobial synergistic infection -- a combination of aerobic bacteria (e.g., $E.$ $coli$, $Klebsiella$, $Proteus$) and anaerobic bacteria (e.g., $Bacteroides$, $Clostridium$, $Peptostreptococcus$). The aerobes consume oxygen, creating a low-oxygen microenvironment that favours anaerobic proliferation, while anaerobes produce toxins (e.g., collagenase, hyaluronidase) that facilitate further spread.
Why the testes are spared: The testes receive blood via the testicular arteries (branches of the abdominal aorta) in addition to cremasteric vessels. These vessels are outside the fascial planes involved in Fournier's gangrene, so the testes retain viability -- hence orchidectomy is NOT done.
Management: Emergency wide surgical debridement + broad-spectrum antibiotics (covering aerobes and anaerobes) + ICU support. Anti-gas gangrene serum is NOT routinely indicated. Urinary diversion is only needed if the urethra/bladder is involved -- not universally required.
\[\boxed{\text{Answer: A -- Mixed aerobic and anaerobic (synergistic) infection}}\]
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