Paediatric Fournier gangrene: comprehensive insights into diagnosis, management, and outcomes-a narrative review.

Abstract

Background and objective: Fournier gangrene (FG) is an uncommon, severe condition characterized by the onset of severe tissue infection in the perineal area, with significant implications for the pediatric population. The current review has been drafted to shed light on the various aspects of pediatric FG, including its etiology, risk factors, clinical presentation, diagnostic approach, management strategies, and outcomes.

Methods: A comprehensive review of pediatric FG was conducted on the existing data on its strategies, clinical features, complications, treatments, and outcomes. A detailed literature search was done on databases using PubMed, Scopus, and Web of Science with keywords such as "Fournier gangrene", "Pediatric Fournier gangrene", "Fournier gangrene in children", and "necrotizing soft tissue infections (NSTI)". Due to the limited pediatric data, adult FG data were used to explain the diagnostic scoring system, treatment strategies.

Key content and findings: The review highlights the prevalence of FG in pediatric populations and reinforces the requirement for early diagnosis with prompt medical intervention to manage pediatric FG. The etiology and pathophysiology of pediatric FG are also discussed, along with the underlying causes and specific risk factors such as existing congenital abnormalities of the genitourinary and gastrointestinal systems. The management of pediatric FG requires the implementation of a multidisciplinary approach, which should begin with immediate clinical intervention, proper surgical procedures, implementation of pharmacological therapies, and antibiotic regimens to avoid potential complications. Preventive strategies should focus on public health education, hygiene, and vaccination to boost immunity and prevent pediatric FG. The current review suggests future directions to ameliorate clinical practices and achieve favourable outcomes in managing pediatric FG.

Conclusions: FG, despite its rare occurrence in the pediatric population, poses a humongous challenge to the healthcare community owing to its rapid onset, complex diagnosis, and high morbidity and mortality rates. Early diagnosis, combined with prompt medical and surgical intervention, with a coordinated multidisciplinary approach, is essential in the management of FG in children. The review provides a glimpse of the shortcomings of the healthcare system and emphasizes the need to improve treatment protocols while also evaluating the long-term impacts of the disease.