Management of Fournier’s Gangrene by Indigenous Ayurveda: A Case Report

Fournier’s gangrene is a severe necrotising fasciitis affecting the perianal, genital and perineal regions. This rapidly progressing and potentially fatal condition involves a polymicrobial infection, causing extensive tissue necrosis. Predominantly affecting middle-aged to older adults, Fournier’s gangrene presents with acute pain, swelling and redness, often accompanied by systemic symptoms like fever and tachycardia. Other risk factors include immunosuppression, chronic alcohol consumption, peripheral vascular disease, and cancer, although cases without known risk factors also occur. Diagnosis is based on clinical suspicion and confirmed through imaging tests such as ultrasound, Computed Tomography (CT), or Magnetic Resonance Imaging (MRI), which reveal soft-tissue gas or fluid collections. Laboratory tests, including blood cultures and inflammatory markers, are crucial for assessing severity and guiding treatment. Immediate and aggressive management is essential, typically involving surgical debridement, broad-spectrum antibiotics, and sometimes reconstructive surgery. Intensive supportive care is often required due to the rapid progression and risk of septic shock. In Ayurveda, Fournier’s gangrene may be related to a condition called Kotha described in ancient texts, with treatment involving surgical excision (Chedana karma), wound care (Shodhana karma), and healing promotion (Ropana karma). A case report of a 68-year-old male patient highlighted the successful integration of Ayurvedic principles and modern medical interventions, resulting in complete recovery without complications. The patient’s treatment included surgical debridement, the use of Ayurvedic medications for wound cleansing and healing, and antibiotics. Regular follow-up and careful wound management were crucial in achieving full recovery, demonstrating the potential efficacy of combining traditional and contemporary medical approaches in managing Fournier’s gangrene.