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Successful treatment following early recognition of a case of Fournier s scrotal
gangrene after a perianal abscess debridement: a case report
#MMPMID29945675
Chen Y
; Wang X
; Lin G
; Xiao R
J Med Case Rep
2018[Jun]; 12
(1
): 193
PMID29945675
show ga
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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