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Necrotising Fasciitis in the Perineum

By Nick Jervis

Necrotising fasciitis is a rare bacterial infection that affects the deep layers of tissue. It can arise in any part of the body, including the perineum (the area of skin between the anus and genitals).

Necrotising fasciitis/Fournier’s Gangrene

Necrotising fasciitis is when a particular type of bacteria gets into the body’s soft tissue and reproduces. This releases a poisonous chemical that damages the surrounding tissue, causing it to break down and eventually die. This is called tissue necrosis.

Necrotising fasciitis can appear in any area of soft tissue, including the perineum and genitals. If this occurs in male patients, the condition is known more specifically as Fournier’s Gangrene.  In female patients it is still called necrotising fasciitis.

Bacterial infection

For necrotising fasciitis to happen, the bacteria must penetrate the skin in order to reach the soft tissue. Ordinarily the bacteria will enter through a break in the skin, which may be a cut so small that the patient was not even aware of it.

Alternatively, the necrotising fasciitis bacteria may enter the body through tissue which is has already begun to break down due to other medical complaints. This might include pressure sores and abscesses.

Necrotising fasciitis in the peri-anal region

Therefore when necrotising fasciitis develops in the perineum/gentials/anus, there may be a history of trauma, such as a cut, graze or surgical wound. Or there may be a primary medical condition that has led to necrotising fasciitis, such as a perineal abscess, a pressure sore on the buttocks or rectal abscess.

Either way, the patient will quickly develop the symptoms associated with necrotising fasciitis, including:-

  • Severe pain that is disproportionate to the injury
  • Fever
  • Skin that is red and hot to touch at the site of infection

There will also be other clinical signs that should prompt medical practitioners to recognise the presence of an infection. These include:-

  • Low blood pressure
  • Fast pulse rate
  • High temperature
  • Swelling and redness in the perineum/buttocks areas.

These abnormal observations should compel medical practitioners to admit a patient to hospital for further investigative tests. This might begin with a full examination to identify the cause of low blood pressure.

Necrotising fasciitis medical negligence

If a patient is discharged home, despite displaying the aforementioned symptoms associated with necrotising fasciitis, the standard of care will have fallen below an acceptable level. If this causes patient to suffer complications – such as extensive debridement and septic shock – there will be grounds for a medical negligence compensation claim. Contact us today to find out more.

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