Fournier's gangrene with retroperitoneal extension, a case report

• Published in: International journal of surgery case reports 2023-04, Vol.105, p.107984, Article 107984
• Main Authors: Molla, Yohannis Derbew, Assefa, Mezgebu Alemneh, Abraha, Aklilu Yiheyis
• Format: Article
• Language: English
• Subjects: Case Report; Fatal disease; Fournier's gangrene; Mortality
• ISSN: 2210-2612; 2210-2612
• DOI: 10.1016/j.ijscr.2023.107984

Fournier's gangrene (FG) is a polymicrobial, both aerobic and anaerobic, synergistic necrotizing fasciitis of the perineal, genital, or perianal regions. It is a rapidly progressive and fulminant soft tissue infection and it is potentially fatal. Fournier's gangrene has been shown to be strongly associated with diabetes, chronic alcoholism, human immunodeficiency virus (HIV), lymphoproliferative diseases, chronic steroid abuse, and cytotoxic drugs. A 25-year-old Ethiopian male patient with no previous medical history presented to the emergency department with a four-day history of perineal pain, swelling, and discharge. Associated with this he had a high-grade fever and one episode of vomiting of ingested matter. On examination, he was febrile, tachycardic, and hypotensive. He had a grossly necrotic scrotum and palpable crepitus extending to the left lower anterior abdominal wall. On investigations, he had elevated leukocyte count, random blood sugar, low hemoglobin, and elevated creatinine levels. Subsequently, the patient was admitted and was started with broad-spectrum antibiotics and multiple debridements were done along with other supportive measures. Finally, the patient was discharged improved after 17 days of hospital stay. Fournier's gangrene is a rapidly progressive, fulminant infection. Nevertheless, prompt diagnosis can be difficult and requires a high index of suspicion. Early diagnosis and appropriate management have paramount importance in reducing mortality and morbidity in these patients. •Fournier's gangrene is a potentially fatal condition.•It is a rapidly progressive infection caused by polymicrobial infection.•Aggressive surgical debridement is the main stay of treatment along with other measures.