Shock – If the surgery is being done to address this problem, there is a high likelihood that this condition has progressed to sepsis/shock. If this is the case, consider the anesthetic implications of shock.

Neuraxial anesthesia – in many cases neuraxial anesthesia will be an appropriate approach. However, assessment of the progression of shock is important to gauge how sympathectomy may exacerbate symptoms. Also, in one case, infection was found in the lower lumbar areas and not evident on the skin surface. CT would be indicated to detect this infection. If a lower back infection is detected/suspected, a general anesthetic would be indicated.

This disease is a bacterial infection of the perineal, genital, or perianal regions. Thrombosis in these areas cause ischemia, infection, and gangrene formation. This is typically in the overlying skin areas, but may spread to the lower areas of the genitourinary tract or anorectal soft tissues. The spread and severity progresses quickly.

Symptoms – skin infection, development of gangrene of the overlying skin and subcutaneous tissues, fever, tachycardia, and volume depletion

Common lab abnormalities (most often due to sepsis) – hyperglycemia, hypocalcemia, anemia, leukocytosis and thrombocytopenia.