Fournier gangrene with concurrent multifocal necrotizing fasciitis: a systematic review and case report

Purpose: A patient presented to a regional surgical center with Fournier gangrene (FG) and concurrent multifocal necrotizing fasci-itis (NF). Given the rarity, it was decided to undertake a systematic review to investigate the incidence and prevalence of FG with mul-tifocal NF and consequently determine the treatment and approach to management of such presentation. Methods: Firstly, the report of the 56-year-old male patient is discussed regarding his surgical management. Secondly, a systematic review was undertaken according to PRISMA guidelines using MEDLINE, Scopus, and Embase databases. Searches used the follow-ing MeSH terms: ("fournier's gangrene") AND ((necrotising fasciitis) OR (necrotising soft tissue infection)). Once the search results were obtained, duplicate articles were removed. Titles, abstracts, and articles were reviewed by 2 authors. Results: The search strategy using the 3 databases revealed a total of 402 studies. Fifty-seven studies were removed due to duplication. A total of 345 records were screened via title and abstract, of which 115 were excluded. Two hundred and thirty studies were reviewed for eligibility. A total of all 230 studies were excluded; 169 were excluded as they included the incorrect patient population (patients suffered from FG or NF, but not both collectively), 60 studies were excluded due to incorrect study designs, and 1 report occurred in the wrong setting. Conclusion: This highlights that while being a relatively known, uncommon infection both FG and NF are well documented sepa-rately within the literature. However, FG with concurrent multifocal NF has not been documented within the literature.