SYSTEMIC COMPLICATIONS OF FOURNIER'S SYNDROME

Abstract

Introduction: Fournier's gangrene has been described as an aggressive necrotizing fasciitis affecting the perineum and genitals, rapidly progressing to deep tissues and triggering severe systemic responses. The literature indicated that the pathophysiology involved polymicrobial infection, with the release of toxins capable of causing endothelial dysfunction, hemodynamic alterations, and an intense inflammatory response. Objective: To analyze the systemic complications related to Fournier's gangrene, synthesizing recent evidence that clarifies the pathophysiological progression, clinical impact, and factors associated with severity. Methodology: The PRISMA checklist was followed, and the PubMed, SciELO, and Web of Science databases were used to search for articles published in the last 10 years. The descriptors used were "Fournier gangrene," "necrotizing fasciitis," "systemic complications," "sepsis," and "clinical outcomes." The inclusion criteria considered studies in humans, full-text articles available, and research addressing systemic complications. Exclusion criteria included duplicate studies, texts that did not analyze systemic manifestations, and publications lacking methodological rigor. Results: Sepsis was the most prevalent systemic complication, followed by septic shock, the occurrence of which was associated with higher mortality. Studies reported acute renal failure resulting from hypoperfusion and rhabdomyolysis, as well as respiratory dysfunction caused by systemic inflammation and the need for prolonged ventilatory support. Conclusion: The review summarized that Fournier's gangrene represents a condition of high systemic impact, marked by a severe inflammatory response and multiple organ dysfunctions. Early identification of complications, combined with multidisciplinary management, was fundamental to reducing mortality.