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  • Title: Successful treatment following early recognition of a case of Fournier's scrotal gangrene after a perianal abscess debridement: a case report.
    Author: Chen Y, Wang X, Lin G, Xiao R.
    Journal: J Med Case Rep; 2018 Jun 27; 12(1):193. PubMed ID: 29945675.
    Abstract:
    BACKGROUND: Fournier's gangrene is an acute surgical emergency characterized by high mortality rates ranging from approximately 13% to 45%. Therefore, aggressive multidisciplinary management is necessary. CASE PRESENTATION: A 29-year-old Asian man who had undergone surgical debridement at another hospital to treat a perianal abscess 5 days earlier was admitted to our hospital for severe scrotal and perianal pain, swelling, and high fever. A physical examination revealed a perianal abscess. Furthermore, the scrotum was gangrenous and exhibited extensive cellulitis in the perineum and bilateral inguinal area. Crepitations between the skin and fascia were palpable. A diagnosis of Fournier's gangrene was made. The patient was treated with immediate surgical debridement under general anesthesia. He received broad-spectrum antibiotics, and debridement was repeated until the wound exhibited healthy granulation. Because both testes were severely exposed, they were transpositioned back into the scrotum 1 week after surgery. The patient was discharged on the 11th postoperative day. CONCLUSIONS: The mainstay of treatment for Fournier's gangrene should include fluid resuscitation, broad-spectrum antibiotic therapy, intensive care, nutritional support, and early aggressive surgical debridement of all necrotic tissue.
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