Department of Urology, Hassan II University Hospital, Fes, MoroccoMorocco
Also available as PDF (figures and tables appear in the PDF).
Fournier’s gangrene is a sometimes life-threatening form of necrotizing fasciitis that affects the genital, perineal, or perianal regions of the body. It is usually secondary to perirectal or periurethral infections associated with local trauma, operative procedures, or urinary tract disease.
Keywords: Fournier’s gangrene; urinary tract disease; periurethral infections
UROLOGY AND ANDROLOGY ISSN 2572-4665 Open Journal Soufiane Ennaciri, MD*; Mustapha Ahsaini, PhD; Moulay Hassan Farih, PhD Department of Urology, Hassan II University Hospital, Fes, Morocco *Corresponding author Soufiane Ennaciri, MD Department of Urology, Hassan II University Hospital, Fes, Morocco; E-mail: soufenna@hotmail.com Article Information Received: February 18th, 2019; Accepted: March 7th, 2019; Published: March 14th, 2019 Cite this article Ennaciri S, Ahsaini M, Farih MH. Fournier’s gangrene in a diabetic young man. Urol Androl Open J. 2019; 3(1): 6. doi: 10.17140/UAOJ-3-117 Fournier's Gangrene in a Diabetic Young Man Illustration | Volume 3 | Number 1| 6 Illustration Copyright 2019 by Ennaciri S. This is an open-access article distributed under Creative Commons Attribution 4.0 International License (CC BY 4.0), which allows to copy, redistribute, remix, transform, and reproduce in any medium or format, even commercially, provided the original work is properly cited. cc F ournier’s gangrene is a sometimes life-threatening form of necrotizing fasciitis that affects the genital, perineal, or peri- anal regions of the body. It is usually secondary to perirectal or periurethral infections associated with local trauma, operative pro- cedures, or urinary tract disease.
We report the case of a 49-years-old man with uncontrolled type 2 diabetes, presented to the emergency department with painful swelling in the scrotum and perianal region. His temperature was 38.8 °C, his pulse 120 beats per minute, and his blood pressure 98/60 mmHg. The physical examination revealed necrosis in the external genitalia and erythema in the hypogastric region and perineum with induration and crepitus (Figure 1A). Computed tomography revealed a scrotal collection with subcutaneous emphysema in the lower abdomen, scrotum and perianal fascia. A diagnosis of Fournier’s gangrene was made.
The treatment consisted of a necrosectomy and drainage of collections with achieving discharge incisions in the perineum and lower abdomen. In addition to surgery, the patient received volume replacement and broad-spectrum intravenous antibiotics.
The evolution was favorable after several days of care (Figure 1B). After that the patient was entrusted to reconstruction surgery.
CONSENT The authors have received written informed consent from the patient.
CONFLICTS OF INTEREST The authors declare that they have no conflicts of interest.
Figure 1. A. Pre-Operative Photo Showing External Genitalianecrosis and Hypogastric Erythema. B. Post-Operative Photo After Excision of the Necrotic Tissue and Discharge Incisions