Fournier's Gangrene in the Emergency Department: Insights from an Age-Stratified Population

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Authors

• Natalie Woodland, Michigan State University College of Human Medicine Medical Student
• Aleezay Khan, Michigan State University College of Human Medicine Medical Student
• Sydney Hudock, Michigan State University College of Human Medicine Medical Student
• Emily Hill, Michigan State University College of Human Medicine Medical Student
• Jon Giolitti, Michigan State University College of Human Medicine Medical Student
• Kimberly Forman, Michigan State University College of Human Medicine Medical Student
• Rachelle Pichot, Graduate Medical Education - Corewell Health West
• Matthew Hysell, Emergency Medicine - Corewell Health South
• Matthew Singh, Emergency Medicine - Corewell Health West
• Jason Seamon, Orthopedic Surgery - Corewell Health West

Description

Fournier's gangrene (FG) is a rapidly progressive necrotizing fasciitis of the perineum and genitalia. Age-related differences in FG presentation and morbidity remain poorly defined. This study evaluated clinical characteristics, management strategies, and complications by age among adults diagnosed with FG in emergency departments (EDs).

A retrospective cohort study was conducted of all adults presenting to the EDs of 11 hospitals in West Michigan with FG from 2012 to 2024. Institutions included rural, community, and university-affiliated hospitals across 19 counties. Demographics, clinical features, treatments, and outcomes were extracted and compared by decade of age. Categorical variables were analyzed using Chi-square or Fisher's exact test; continuous variables with a two-sample t-test.

During the study period, 166 patients were treated for FG; 19.3% were female. Patients were predominantly white (78% males, 82% females); the mean age was 54.9 years (range, 23-91 years). FG among young adults (< 40) was diagnosed in 21 patients (12.7%) and was associated with trauma, HIV, immunodeficiency, or diabetes, often with rapid onset and classic symptoms prompting early admission. In 35.5% of those under age 50, tissue necrosis was limited unless the diagnosis was delayed or the patient was immunocompromised. Hospital stays were shorter, and fewer repeat debridement were required for patients over age 50. Older adults (>60) more often had extensive necrosis, atypical symptoms, and delayed admission. Overall, 30-day mortality was 12.1%.

Fournier's gangrene in younger adults is typically precipitated by trauma, immunodeficiency, or diabetes, and tends to present rapidly with classic symptoms, resulting in less extensive disease and better outcomes than older adults. In contrast, older patients are more likely to have delayed and atypical presentations, extensive tissue involvement, and higher morbidity. These results underscore the importance of age-specific clinical vigilance and prompt management to optimize outcomes in FG.

Publication Date

5-8-2026

Disciplines

Emergency Medicine

Recommended Citation

Woodland N, Khan A, Hudock S, Hill E, Giolitti J, Forman K, Pichot R, Hysell M, Singh M, Seamon J. Fournier's gangrene in the emergency department: Insights from an age-stratified population. Presented at: Research Day Corewell Health West; 2026 May 8; Grand Rapids, MI.

Comments

2026 Research Day Corewell Health West, Grand Rapids, MI, May 8, 2026. Abstract 1883