Abstract
Background A 59-year-old man presented with a 4-day history of scrotal pain and swelling and the rapid development of moist, black, foul-smelling lesions on the scrotum and penis. As a liver-transplant recipient, he was immunosuppressed. He also had type 1 (insulin-dependent) diabetes and poor nutrition, which might have compromised immunity further.
Investigations Physical examination, blood and tissue cultures, full blood count, urea and electrolytes, liver function tests, coagulation profile, C-reactive protein, and examination under anesthesia.
Diagnosis Fournier's gangrene originating from an infected cutaneous lesion in an immunocompromised patient.
Management Resuscitation and triple broad-spectrum antibiotics, urgent surgical debridement, serial examinations under anesthesia with further debridements, and split-skin grafting. Phallic reconstruction is planned.
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'Aho, T., Canal, A. & Neal, D. Fournier's gangrene. Nat Rev Urol 3, 54–57 (2006). https://doi.org/10.1038/ncpuro0353
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DOI: https://doi.org/10.1038/ncpuro0353