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General Surgery · Urology: Fournier gangrene
Sample itemA patient with diabetes has severe perineal pain, rapidly spreading erythema, crepitus, fever, and hypotension. What is the most appropriate management?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
A. Immediate broad-spectrum antibiotics and urgent surgical debridement
Fournier gangrene is a necrotizing soft-tissue infection of the perineum and genital region. Survival depends on rapid resuscitation, broad antimicrobial therapy, and aggressive repeated surgical debridement.
Option by option
A. Immediate broad-spectrum antibiotics and urgent surgical debridement (correct)
Correct. This presentation requires immediate source control and sepsis management.
B. Observation after oral analgesia
Observation risks fulminant septic shock and extensive tissue loss.
C. Topical antifungal treatment only
Topical treatment cannot penetrate or control a necrotizing infection.
D. Elective outpatient skin biopsy
Biopsy should not delay life-saving debridement.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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