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December 1996

Picture of the Month

Author Affiliations

From the Department of Pediatrics (Dr Huang) and Division of Pediatric Surgery, Department of Surgery (Dr Chuang), Chang Gung Memorial Hospital, Kaohsiung, Taiwan; and the American Board of Pediatrics, Chapel Hill, NC (Dr Tunnessen).

Arch Pediatr Adolesc Med. 1996;150(12):1307-1308. doi:10.1001/archpedi.1996.02170370085015

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AN 8-MONTH-OLD male infant with a 7-day history of fever and a 5-day history of obstipation was seen for abdominal distension. On physical examination, the infant was in acute distress, with a distended abdomen and absent bowel sounds. His perianal area was erythematous and indurated and had a number of deep, punched-out ulcerations (Figure 1). The white blood cell count was increased, and the platelet count and hemoglobin concentration were decreased. Laparotomy disclosed diffusely dilated loops of bowel and multiple colonic ulcerations (Figure 2).

Denouement and Discussion 

Fournier Gangrene  FOURNIER GANGRENE, a necrotizing fasciitis of the perianal and periscrotal regions, has been reported uncommonly in children.1 The onset of this form of fasciitis is usually acute, with the rapid spread of inflammation, induration, and tissue necrosis. Affected areas are not usually well demarcated, and the erythema and induration may resemble cellulitis until color changes suggestive of gangrene begin to

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