From the perineum to the clavicle: a possible path
When to know the anatomy is key for a diagnosis. How an infection starting in the pelvic area can reach the infraclavicular area? There are virtual paths for dissemination inside the body, and very often
they are not checked routinely during a physical examination. One example is the perineum, only specifically examined in situations such as a rectal or prostate cancer. In the next picture we show a case of Fournier´s gangrene located in the perineum
Mechanism of dissemination
Fournier’s gangrene is a fatal necrotising fasciitis of the perineum, genitals and lower abdomen. Patients often need an aggressive surgical debridement, but if there is a delay in the identification or in the treatment, the infection could reach even the infraclavicular area. There is a path between the outer peritoneal layer and the inner layer of the abdominal cavity, starting in the pelvic area and finishing close to the infraclavicular area.