Case report: Fournier's gangrene in the context of peritonitis secondary to perforated appendicitis

Fournier’s gangrene (FG) is an infrequent and rapidly progressive clinical condition, classified among necrotizing fasciitis, predominantly affecting the perineal, genital, and perianal regions. In certain cases, involvement of the gastrointestinal mucosa secondary to the spread of infection has been documented. The estimated incidence is approximately 1.6 cases per 100,000 males, as it is a condition exclusive to the male sex, associated with the anatomical characteristics of the perineum and scrotum that facilitate the rapid dissemination of infection in this region. (Stevens & Madourr, 2024). From an etiopathogenic standpoint, FG results from a polymicrobial infection involving both aerobic and anaerobic bacteria, which requires immediate therapeutic intervention based on aggressive surgical debridement and broad-spectrum antibiotic coverage. Early recognition is essential to reduce the high associated mortality rate. Risk factors play a crucial role in the development of this condition, with comorbidities—particularly diabetes mellitus, immunosuppression, and septic states—being the most relevant. The following case report presents the development of Fournier’s gangrene in the context of peritonitis secondary to perforated appendicitis, illustrating the need for a comprehensive and timely diagnostic approach to improve patient outcomes.