What Is Fournier’s Gangrene?

Medically Reviewed by Zilpah Sheikh, MD on November 08, 2023
7 min read

Fournier’s gangrene is a very serious, sometimes fatal infection in your genital or anal area. It’s a type of necrotizing fasciitis (flesh-eating disease) that develops quickly.

Gangrene happens when body tissue is dead or is dying because it’s infected or isn’t getting enough blood. Fournier’s gangrene usually involves an infection that gets under the skin of the scrotum (the sac holding the testicles), the penis, or the perineum. The perineum is the area between the penis and the anus or between the vulva (the outer part of the vagina) and the anus.

Under the skin, the infection spreads quickly and starts to destroy soft tissues surrounding your muscles, arteries, and nerves. In the worst cases, the dead or dying tissue can stretch to the thighs, stomach, and chest.

Is Fournier's gangrene an emergency?

Yes, Fournier’s gangrene gets worse quickly and can kill you, so it’s always an emergency.


The disease is very rare. About 1.6 per 100,000 men and many fewer women or children get it each year. One study that looked at 10.7 million hospitalized men and boys found 2,238 cases of Fournier’s gangrene. The same study found just 49 cases in more than 15 million hospitalized women and girls.

Rates are highest in men over age 50. In the United States, it's most common in the South.

It’s not clear how often people who get Fournier’s gangrene die from it. Some studies say the death rate could be as low as 7.5 %; most studies put the rate at 20% to 40%.


What does Fournier’s gangrene feel like?

The first thing you might notice is sudden pain or tenderness in the genitals or the area between the genitals and the anus (the perineum). Then you might start to feel sick all over. For example, you might feel tired, sick to your stomach, and get a fever.

What does Fournier’s gangrene look like?

If you have Fournier's gangrene, the skin on the affected body parts changes color. First, it’s red or purple, then bluish gray and, finally, black. These changes may be hard to see if your skin is dark.

Early symptoms of Fournier’s gangrene: 

  • Your penis, vulva, scrotum, or perineum looks red or purple. 
  • You feel sore around your genitals or in the area between your genitals and your anus.
  • These areas might start to swell.

If you have these early symptoms, call your doctor right away. Don’t wait to see if things get worse.

Later symptoms of Fournier’s gangrene:

These vary from person to person, but can include:

  • Pain around the genitals or anus that gets worse
  • Pain in your belly
  • Color changes in the sore area
  • A bad smell from the sore area
  • Itchiness
  • A popping sound when you rub the sore area
  • Fever and chills
  • A fast heart rate
  • Low blood pressure
  • Confusion
  • Nausea and vomiting
  • Low energy

Fournier’s gangrene usually involves an infection with bacteria. The bacteria can get into tissues under your skin in several ways. These include:

  • Urinary tract infections
  • Bladder infections
  • Surgery
  • Abscesses, infected wounds that drain pus. You can get these near the anus or vulva. 
  • Genital piercings
  • Insect bites
  • Injuries during sex
  • Any injury that causes a scratch or burn
  • Circumcision in children

Causes in women: If you have female anatomy, Fournier’s gangrene most often happens due to an abscess near your anus or on your vulva. Other causes can include injuries from surgery or radiation treatments.

You might get infected with several kinds of bacteria. The most common found in people with Fournier’s gangrene include:

  • Group A streptococci 
  • Staphylococcus aureus
  • E. coli 
  • Pseudomonas aeruginosa



Fournier’s gangrene is most common in people who have a weak immune system or other health problems. You're more likely to get Fournier’s gangrene if you have:

  • Diabetes. Between 20% and 70% of people who get Fournier’s gangrene have diabetes. But most people with diabetes won’t get Fournier’s gangrene.
  • Alcohol misuse problems
  • HIV infection
  • Liver damage
  • High blood pressure
  • Kidney failure
  • Obesity
  • Heart disease

Your risk also is higher if you're:

  • Over 50
  • A smoker
  • Getting chemotherapy
  • Taking steroid drugs

Fournier's gangrene can affect people of any age and gender. Some cases have been reported in infants. But the peak risk is in men ages 50-60. Because secretions can drain through your vagina, having female anatomy seems to lower risks. 

Can diabetes drugs cause Fournier’s gangrene?

The FDA has reported cases in people with type 2 diabetes who were taking certain drugs to lower their blood sugar. These drugs are called SGLT2 inhibitors and include medications such as canagliflozin (Invokana), dapagliflozin (Farxiga), empagliflozin (Jardiance), and ertugliflozin (Steglatro).

It’s not clear why people taking those drugs might have a higher risk. One possibility is that the drugs increase the risk of urinary tract infections.

If your doctor thinks you may have Fournier's gangrene, they will ask about your symptoms and look at your skin. If you're in danger, you might start treatment without any other tests. If you do get tests, they could include:

  • A computerized tomography (CT) scan that might help find where the infection is
  • An ultrasound exam that can help rule out other problems that cause similar symptoms
  • X-rays that look for gas in the damaged tissues. Gas is released from some of the bacteria that cause Fournier’s gangrene
  • Blood tests to look for signs of infections and other clues

The main treatments for Fournier’s gangrene are surgery and antibiotics.

You may get surgery very quickly after diagnosis. The doctor will remove as much dead skin and tissue as possible to stop the damage from getting any worse. That kind of surgery is called debridement. You might need several of these surgeries to get rid of all the dead tissue. In rare cases, the entire penis and scrotum might be removed. 

You'll get antibiotics, drugs to kill the bacteria damaging your body. You may need several kinds of antibiotics. Instead of taking pills, you will get them through an IV, so that the medicine can get directly into your veins. That can kill the harmful bacteria more quickly.

Once the infection is under control, you can get reconstructive surgery. The goal will be for your body to look the way it did before the gangrene, if possible.

You might also get something called hyperbaric oxygen therapy. That’s when you sit in a special room or lie in a tube with high oxygen levels. The oxygen can help heal wounds and stop bacteria from growing.

Recovery from Fournier’s gangrene can take a while. You might spend several weeks in the hospital.


If Fournier’s gangrene isn't stopped in the earliest stages, you can get serious complications. These can include:

  • Sepsis. When you have an extreme reaction to an infection, inflammation can spread through your body. This is a dangerous situation and can cause your blood pressure to plunge. The most extreme form of sepsis is called septic shock.
  • Organ failure. Your major organs, like your kidneys, heart, and lungs, can stop working when you have sepsis.
  • Blood clots. The inflammation can also make blood cells clump up in your arteries and veins. Blood clots can cause strokes and heart attacks.

Complications for women: While women (and those identified as female at birth) are less likely to get Fournier’s gangrene, they often get sicker from it. For example, they spend more days in the hospital and are more likely to need help from breathing machines and other intensive care.

You're more likely to survive Fournier’s gangrene than to die from it.  But after the crisis, you might have some lingering problems. These can include:

  • Sexual problems. You might, for example, lose feeling in your genitals and have problems with erections.
  • Needing a colostomy bag. That’s a bag attached to your belly to collect poop when you can’t poop through your anus. Using the bag for a while may help you heal. 
  • Depression 
  • Digestive problems 
  • Urinary tract infections
  • Ongoing pain

You might need to see more than one medical specialist to deal with such issues and help improve your quality of life.

There are some steps you can take to lower your chances of getting Fournier’s gangrene:

  • If you have diabetes, regularly check your genitals and surrounding areas for wounds or signs of infection, like redness and swelling.
  • Keep your blood sugar at a healthy level. For people with diabetes, that means keeping up with your medications.
  • If you're obese or overweight, try to lose some weight. Ask your doctor about the best ways to do this.
  • If you smoke or chew tobacco, stop.
  • To lower your risk of infection, wash any open wounds in the area with soap and water and keep them dry and clean until they heal.
  • Keep your genital and anal areas clean and dry.


Fournier’s gangrene is a life-threatening infection. It usually starts with redness, swelling, and pain around your genitals or anus. If you have possible signs, it’s very important to see a doctor right away. Early treatment can save your life.

What is the most common cause of Fournier’s gangrene?

The most common causes are infections in your urinary tract or the area near your anus that make their way into other tissues. 

Is Fournier’s gangrene an STD (a sexually transmitted disease, also known as an STI, or sexually transmitted infection)?

No. You can’t get Fournier’s gangrene from another person or pass it to someone else. Sexual  activity can play a role if it causes cuts in your skin when you have already have an infection. 

Is Fournier’s gangrene caused by poor hygiene?

Poor hygiene doesn't cause the disease. But keeping your genitals and perineum clean can help lower your risk.

Can you survive Fournier’s gangrene?

Most people survive. Some small, older studies found death rates higher than 50%. But larger, more recent studies mostly show death rates in the 20%-40% range. The largest studies find even lower death rates of 7.5% to 16%. Getting clear answers is hard because Fournier’s gangrene is so rare.

One thing is clear: The more quickly you get treatment, the more likely you are to survive.